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Ballgame, December 21,  2018  4:58pm EST

HBP and Dysautonomic disorders

, I'm a 72 y-o male who had well-controlled ( Verapamil 240 ER) for 20 years ; very active lifestyle as a practicing oral and maxillofacial surgeon, gym 3 x week , golf  twice / week  In Feb 2018, I had a bizarre spike in my BP to 210-220 / 110-120 , P = mid 80s. , very weak . After a few hours went to ER ( I ws in Vegas) and had a full work-up brain CT, cardiac enzymes , ecg, etc.Diagnosed with anxiety which was total BS which I clatrify later. Over a few months I returned to "normal"  ; my cardiologist did ecjho, cardiac stress CT , etc. all was normal. Then in mid- April  "IT" happened again while walking my dog. BPs > 200/100 , weak , pre-syncopal. Same crazy , costly work-up at ER with cardiologist admitting me . Changed meds to Labetalol 100mg bid . Progressively,  my BPs became harder to control : i became less exertion tolerant . To the point , after researching Medline etc, I came to believe ( and requested referral)  that I may have a form of dysautonomic disorder . Bingo : after referral in July  to a Autonomic specialist I was diagnosed with adrenergic and cardiovagal dysfunction and orthostatic hypotension , in conjunction with supine hypertension . I am now on 300mg of labetalol and 160 Valsartan bid and I still have BP control issues . BTW, "anxiety " is the common misdiagnosis for autonomic disorders . Doctors are untrained or unfamiliar with its signs and symptoms. Maybe food for thought for someone out there . It's unfortunately something I have to live with and take the good times with the :less good" Obviously the HPI ( history of present illness) is a much more detailed story. 

2 Replies
  • yarn007
    yarn007, December 24,  2018  4:49am EST

    Wow, thanks for the heads up.   Food for thought posts are so helpful to others.   So, glad to hear you did some research and advocated for yourself and managed to get the right diagnosis.   Are you feeling better now that they are treating you correctly?   Doesn't it make you crazy when you see how much blood work costs?

  • flyhuntress
    flyhuntress, January 13,  2019  8:09am EST

    Thanks for the info about anxiety misdiagnosis. I'll add that awareness to my bag of tricks.

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