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What Causes Light Headedness, High BP And Heart Palpitations?

Posted on Tue, 5 Apr 2016

Question: 25 year old male, Ankylosing Spondylitis, pretty bad spinal vertebra and disc heberation, has had spinal stenosis surgery, chronic pain, muscle spasms , on Enbrel, now has pulse usually over 100, shooting up to 150 at times, sometimes goes low, light headed, blood pressure growing higher around 139/98 ish throughout day . Ecg and ultrasound reportedly ok. I asked for tilt test and he began to pass out towards end of the 30 minutes. But his blood pressure had not dropped 30 degrees lower than at the start, Dr guesses it's just the pain. What labs and other tests should be done? We think something else is being missed. He failed tilt test in 2006 before he had spinal stenosis surgery, and at the time we guessed that the stenosis had something to do with it. But his pulse and bp were not high then. This is new. He wears a Fitbit now to make sure it isn't getting higher than 150. Won't his heart wear out, get fatigues, if it stays at 100-150?

Answered by Dr. Ronald Schubert (52 minutes later)

Brief Answer:
Tachycardia

Detailed Answer:
Thank you for contacting HCM with your health care concerns

I am sorry to hear that you son is having problems with his heart rate. I understand that his ECG and ultrasound are normal. I also read back in his history that he had a 24 hour ECG which only showed spikes in his heart rate without any arrythmia.

With everything including his labs being normal there is little else that can be done. Perhaps his overall physical endurance is low. He should gradually increase his physical stamina with walking. If he can't walk then he should try swimming. Even a little exercise will help him

I hope this answers your question. Please contact us again if you have any additional questions

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ronald Schubert (19 hours later)

He has herniated discs at C2-3, C5-6, and foriminal stenosis in several cervical vertebra. I perceive that C6-6 nerves innervate heart, among other things. Also, minor slipped disc of c5 over C6. This is in 2013 cervical MRI report. Could nerve pressure due to this degeneration cause his rising pulse and blood pressure, and dizziness when he stands up? He also is having a lot of muscle spasm in neck and pain under shoulder blade.

Answered by Dr. Ronald Schubert (4 minutes later)

Brief Answer:
No correlation with Herniated disks and heart disease

Detailed Answer:
The herniation of his disks will not affect the heart. The herniation will impinge on the motor nerve and not the autonomic nerves

His heart may increase though if he is having marked increase in pain. Tachycardia is a sign of pain. He maybe getting increased pain and spasms then his heart rate increasing and then the light headedness and near syncope. He should try to control his pain to see if that help stops the tachycardia

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar