Elevated Pulse and Systolic Pressure on Standing Without Change in Diastolic Pressure
I am an 18-year-old male from Egypt, standing at 6 feet 1 inch and weighing 90 kg. Medical Background: I have been diagnosed with a bicuspid aortic valve that has progressed from causing mild aortic regurgitation to now being moderate to severe along with mild stenosis. Additionally, I seem to exhibit symptoms consistent with Meige's syndrome, which has been present since I was 12 years old. Lately, I have been experiencing a variety of symptoms including palpitations, shortness of breath, sensitivity to light, aura migraines, increased heart rate, eyelid twitching on the right side, and most troubling of all, dizziness when I stand up. The tachycardia was the first symptom to manifest, which was accompanied by excessive sweating upon standing. My blood pressure measurements indicated a systolic reading of 160/70, occasionally reaching as high as 180/90 during stressful moments. An echocardiogram, performed during a tachycardic episode, revealed severe regurgitation and mild stenosis. I was subsequently prescribed a 5 mg dosage of beta blockers, which has been effective most of the time. A follow-up echocardiogram two weeks later showed moderate regurgitation and mild stenosis, along with signs of left ventricular hypertrophy. Following this, I began experiencing photophobia (where everything appears excessively bright), right eyelid twitching, and light-headedness upon standing, particularly more than six hours after taking my beta blockers. I have consistently monitored my heart rate while seated over several days, averaging around 70 beats per minute. However, when I stand, my heart rate often surges to between 90 and 110. My blood pressure also increases from 120 systolic to between 150 and 165, while my diastolic pressure remains relatively unchanged, averaging 50-60. In addition, I underwent a duplex scan on my neck that indicated a resistance of 0.87 in my right vertebral artery, compared to 0.67 on the left. At this point, I am still trying to understand how all these various factors may be interconnected.
Answers (1)
6/18/2025, 8:50:44 PM
OpenHealth AI
Your symptoms and medical background suggest a complex interaction of cardiovascular and neurological issues, especially with your history of a bicuspid aortic valve and signs suggesting Meige's syndrome. It’s understandable to feel overwhelmed given the variety of symptoms you're experiencing, including elevated heart rate and blood pressure upon standing, dizziness, and vision changes. Here, I’ll clarify the potential connections and give you some immediate guidance.
Main Points:
- You are experiencing orthostatic changes in heart rate and blood pressure, which can be influenced by your heart condition and possibly related to Meige's syndrome.
- Symptoms like dizziness, palpitations, and sensitivity to light need monitoring and careful management, especially in the context of your cardiac history.
Explanation:
- Orthostatic Response: Your symptoms when standing - increased heart rate and systolic blood pressure - indicate a possible orthostatic response. This may be a result of autonomic dysfunction often seen in conditions related to nerve responses, like Meige's syndrome.
- Bicuspid Aortic Valve: This can cause irregularities in blood flow and pressure changes. The severe regurgitation and mild stenosis can complicate your hemodynamics, leading to symptoms like tachycardia.
- Eyelid Twitching and Photophobia: These may be neurological symptoms tied to environmental sensitivities or stress responses.
Next Steps:
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Monitor Your Symptoms: Keep a detailed journal of your symptoms including when they occur, their intensity, and any potential triggers (like stress or changes in position). This will help identify patterns that can aid in symptom management.
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Gradual Posture Changes: When moving from sitting to standing, take your time. Engage in slow transitions to help your body adjust and potentially reduce dizziness.
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Hydration and Salt Intake: Ensure you are well-hydrated and consider increasing your salt intake (under guidance) if it’s safe for you and if your healthcare provider approves. This can help increase blood volume and combat low blood pressure.
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Consistent Timing for Beta Blockers: If the effects of your beta blockers seem to wear off, discuss with your healthcare provider about possible adjusting the timing or dosage to maintain stable levels throughout the day.
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Collaborate with Specialists: Given your complex symptoms, it may be beneficial to work closely with a cardiologist and a neurologist to manage both your cardiovascular and neurological symptoms effectively.
Your health is of utmost importance, and while these symptoms can be concerning, they can often be managed effectively with careful monitoring and tailored interventions. Please prioritize discussing any significant changes or concerns with your healthcare provider.
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