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Bp/pulse Rate Jumps To 155+ When Sit Or Stand. What To Do?

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Posted on Fri, 30 Aug 2013
Question: Hi I am a 34yr old female bp normally fine but everytime I sit or squat the stand my bp/pulse rate jumps to 155+ and I see spots like im going to pass out what could this be as they did the lay down sit up test and I was fine it's just from sitting,squatting and tonight bending over to standing.
doctor
Answered by Dr. Sukhvinder Singh (58 minutes later)
Respected Ma'm
I would like to know a few details before we discuss this issue.
1. Since how long this problem is there?
2.Do you feel it every time you stand from squatting position or lying down position? 3. Are you taking any medications currently (for any reason)?
4. Do you have any recent viral illness/ fever/ any illness with loss of body fluids?
5. Does this results in increase in heart rate only or BP too? Specifically I wish to know what happens to BP? When do you measure it?
6. Does this happen in sitting postures too or on sudden movement of neck?
7. Please mention any concurrent illness you have.
I would be glad to answer you, once you revert back with these details.
Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (56 minutes later)
1> started around february 2013 although i felt off balance XXXXXXX 2012 from sinus but normal again july 2012
2> yes i'd say 8/10 times with squatting, sitting (on ground), bending over has been more recent. laying down no issues i had to pull car over the other week as it happened while driving.
3> I am on anatolol 50mg x2 per day but it doesn't really help much
4>nothing
5> the dr checks bp eaxh time i go last visit was friday 140/65 or 65/140 normally it's 60/100 or 100/60 however it goes. the nurse does the test and all she said was oh my god your pulse rate jumped to 155 then it was 157+ on other 2 squat to stand tests but if i just lay to stand it's normal.
6> over last 3 weeks sometimes if im sitting and then stand, sometimes just sitting but generally its from on ground/step to standing position. when i wake out of bed no issues.
7> no illness
thanks XXXXX


also it's like sometimes i can feel a pressure once black spots go and once i feel it hit my toes im fine again. my husband said yesterday my eyes went rolly when it happened. i don't know what it is but i don't like it and need to get it to go away. it happens weather im not stressed and worsens when i get stresed my gp said not running any tests until i faint but i dont let myself faint i always am near a wall or able to hold something or get to the ground quickly before i fall down
doctor
Answered by Dr. Sukhvinder Singh (29 minutes later)
Respected Ma'm
Thanks for the details.
1. If it happened while driving the car, that means the trigger was not a change in posture! That's a new twist to the history narrated by you till now. Because until now, my focus was on posture related increase in heart rate and fall in BP, producing kind of giddiness, spots in front of eyes and impending "passing out". I hope you are pretty sure about this episode while driving car. Can you narrate this in detail especially mention what happened and was there any postural change involved.
2. There are three broad possibilities as per the details you provided.
A. One was a fall in BP and increase in heart rate on assuming upright posture. This phenomenon can happen in postural hypotension/ orthostatic hypotension or higher than normal blood pressure is against this phenomenon. Do you ever feel Short of breath on using stairs?
C. There is some transient neurological event, leading to loss of consciousness or near loss of consciousness which you obviously denied. Neurological causes like seizures etc are also associated with tongue bite/ head injury and incontinence and more often than not they will last longer than few seconds.
3. Rolling of eye ball is again a significant thing. You must tell this to your GP on priority. This is usually a sign of neurological involvement (say seizures) but has been well described in postural hypotension patients also.
4. I hope you get an idea that how I am thinking on this issue. All three possibilities can be there with few points against each of them. I will dissect out more if you can provide me more details. In fact I am keen to get more details from you about the episodes and precipitants and total duration of episodes beside any point related to the details i wrote above.
5. One thing is pretty sure that it is not something to be taken lightly. You must press upon your GP with all the details to get you evaluated on priority.
I am waiting for more details from your side to discuss further.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (1 hour later)
the car issue was a definate extreme stress trigger, my husband was with me at the time he couldn't drive due to medication, prior by aprox 45 mins XXXXXXX we left the dr's office i was very stressed opened the car door and half fainted i mean when i say this i saw the spots and just basically let myself fall into the drivers seat when the door was open(my husband didn't quite notice this), then after 10 mins he asked y we were still sitting in the car not going i was unable to drive everytime i thought i had calmed and went to start car the spots and pass out feeling would come. I have never ever had it happen that badly before as i did that day now that would actually have been around 2:40 ish on 1/august as sson as i got us home i had another half of the atenolol 50mg it barely worked.
again a very extremely stressful time that day.
normally and for months it has been if i am squatting, sitting on floor or on a low step and kneeling(when i really think back) so basically anything where i am low. more so lately it's included bending (but not every time). a few times well over 10 i have had it sitting in the chair including at the gp's when i have gotten up. the strange thing is when they test me laying to upright im fine.
as soon as im low to upright the pulserate skyrockets(so they have told me) and i see the spots ect.
at the beach tonight it came on about 5 seconds after i stood now im 158cm high and its like i feel it come on see the spots do what i do to not pass out / fall then when i feel the wave / pressure as such go to my toes im fine. how long that is i'd say XXXXXXX 90-120 seconds sometime 20 seconds ive never timed it but at times it feels worse. sometimes when i do stairs at work(at school) yes i get out of breath and i guess a little tight. i know i get puffed walking quickly from 1 end of school to another. i know part will be stress but its been going on longer that i have been stressed. I try not to night drive as sometimes my eyes feel weird if that makes sense by my last eye test showed vision is fine. hope that helps a little more.

The tips of my fingers felt numb and tingly now i think that was 2 weeks ago but doesnt happen now i keep forgetting to tell my gp. should i be worried i just want what ever it is to go away. oh and also sometimes i can feel my heart beat a bit harder like when you've exercised but i hadn,t i cant tell you how often cos i don't really pay attention to it but it happened just before like in the last 20 mins.
that shoulder muscle is feeling achey and tight again but not on right side.


with my eyes feeling like they move after my head or heavy as such that is more when ive moved my head but black out spots isn't that ive noticed. also weight is 57.5 /6 / 7 changes between the 3if u needed that info

to finish answering your q with car i said to my husband im gonna pass out and was already in L XXXXXXX so i swerved as such into the part you pull over to on the road ( it was a normal street where you do 60km p/hr). didn't completely lose vision but lots of spots when it finished i waited about a minute to be sure and drove off again (that was 2mins from our house)

my gp is well aware of all of what's happened but said until i collapse he wont run tests so thats why im on here to find out whats going on. im thinking i need a new gp but will talk again to gp on monday do you have suggestions on what im am asking gp to test / check?
doctor
Answered by Dr. Sukhvinder Singh (47 minutes later)
Respected Ma'm
Thanks for the details.
1. If you can redo that maneuver with which those spots in front of eyes /feeling of passing out comes in front of your GP and let your GP examine you at that particular time, this will be the best possible thing. If you could really reproduce that episode, it will rule out 2 things; first the neurological cause pertaining to brain and second the heart rhythm disorder. Then he may proceed as per the examination findings at that time. He may also attach an ECG or a cardiac monitor to your chest and let you repeat that maneuver. Else ask him to examine you thoroughly for central nervous system including autonomic nervous system (like checking your BP lying down and after 2 minutes of assuming the upright posture and see the difference ; checking difference between your supine and standing pulse rates etc.). Also let him examine your cardiac system thoroughly.
2. In absence of clear-cut clues a number of tests could be done. However I feel the examination will definitely give out some clues.
3. As per the history given by you as yet, I feel first possibility is autonomic nervous system abnormality (which I detailed in 2A in my previous answer) and this may require examination by a more expert fellow like a neurologist. Other possibilities will come at lower ranks.
Hope this helps. Please feel free to discuss further.
Sincerely
Sukhvinder XXXXXXX
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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Bp/pulse Rate Jumps To 155+ When Sit Or Stand. What To Do?

Respected Ma'm
I would like to know a few details before we discuss this issue.
1. Since how long this problem is there?
2.Do you feel it every time you stand from squatting position or lying down position? 3. Are you taking any medications currently (for any reason)?
4. Do you have any recent viral illness/ fever/ any illness with loss of body fluids?
5. Does this results in increase in heart rate only or BP too? Specifically I wish to know what happens to BP? When do you measure it?
6. Does this happen in sitting postures too or on sudden movement of neck?
7. Please mention any concurrent illness you have.
I would be glad to answer you, once you revert back with these details.
Sincerely
Sukhvinder XXXXXXX