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Thread: Risk of Heart Disease from Extreme Fluctuations in Blood Pressure

  1. #1

    Risk of Heart Disease from Extreme Fluctuations in Blood Pressure

    I need to find a specialist, specifically someone familiar with spinal cord injury and blood pressure. I need to figure out how to stop extreme high and low blood pressure fluctuations. I'm also worried about efect these severe changes do to the elastisity of the blood vessels and the risk to heart disease.

    The doctors at my local hospital won't believe me when I tell them that my blood pressure was less then 58/32 diastolic before I got out of bed and then a few hours later in my chair, it was 168/153. I've never come close to that reading before and was pretty shaky.

    Yesterday, the ER doctor smirked at me and said it was physiologically impossible and that I would have died. He also ignored my documents I brought to him describing autonomic dysreflexia. He said myBP machine was inaccurate. But we calibrated it and, checked my caregivers BP that was correct.

    While it didn't go as high at the ER, it was high and low enough for him to finally see that I wasn't making it up. Of course, he blamed their BP machines as being defective and had to try a couple of them for verification.

    With those readings, I don't understand why I'm not dead either. I want to protect myself from suffering a stroke or heart attack.

    So I'm wondering if spinal cord injury blood pressure isn't the same as others. It doesn't stay long at that level. It decreases within five minutes. Nonetheless , I wonder if any elasticity damage is done to blood vessels and arteries from all the pressure changes to increase risk for heart disease

  2. #2
    Over time, extreme increases in BP such as occurs with AD can cause some cardiac damage, but it is not to the blood vessels, but to the heart muscle.

    I think you need to find a different cardiologist, perhaps one who also specializes in autonomic dysfunction. You might want to see someone at your local university teaching hospital, as they often have specialists in this type of thing, and may find your case challenging as a teaching case.

    I would also strongly recommend that you contact the Patient Advocate or Representative at the hospital you reference above about the lack of respect you have been shown there. This is not acceptable and it should be pursued by their risk management department with the providers involved. I hope you took names.

    (KLD)

  3. #3
    I think you need to find a different cardiologist, perhaps one who also specializes in autonomic dysfunction. You might want to see someone at your local university teaching hospital, as they often have specialists in this type of thing, and may find your case challenging as a teaching case.
    Could you recommend a cardiologist who also specializes in autonomic dysfunction in the San Diego or southern CA Region?

  4. #4
    .would also strongly recommend that you contact the Patient Advocate or Representative at the hospital you reference above about the lack of respect you have been shown there. This is not acceptable and it should be pursued by their risk management department with the providers involved. I hope you took names.
    Yes I have a d plan to request an in-service about autonomic dysreflexia. This is third instance of nurses and doctors not listening to me about it. I always bring a fact sheet with me.

    The other two instances resulted in unecessary and dangerous results. The first, when I warned a nurse that I had to be careful with bowel evacuation, she ignored me and told me she was an old hand at it. She didn't know how to do it for a quad. My BP was rising and I made repeated requests to take my BP. She refused and told the staff not to do it either cuz she had already done my vitals an hour ago.

    When I get really dysreflexic I get very emotional and confused. I tried to show her that AD could be fatal on my iPad. I begged for a supervisor. Nurse wouldn't let me talk, but did herself. Don't know what she said, but wanted to force an Ativan on me stating I was causing my BP to increase because I was too anxious.

    At some point in the night, someone realized I did, in fact, have a valid medical condition. Lots of apologies and the best and most knowledgeable nurses only were assigned to me from then on. I think the bad nurse was fired over it.

    The second time it was my attending physician in ICU. I told him 1st thing about AD and to call my SCI doctor. But he was too arrogant and put me through some horrible experiences. Day three, dumbfounded, he finally contacts my SCI doctor and announces to me I may have a condition called autonomic dysreflexia. really, now why didn't you just listen to me and we could have all been through less stress.

  5. #5
    My cardiologist has done some research into the incidence of heart arrhythmias in spinal cord injured. My injury is C6/7 complete and about 15 years post injury, I developed atrial fibrillation. He has speculated with me as to the possibility of autonomia having some causative impact.

    I was cardioverted three times and for several years took medication to try to keep the heart in rhythm with little success. But, since the arrhythmia is fairly mild, the cardiologist took me off all medications. I have had tests over the years to evaluate any heart muscle damage and to date have no damage.

    All the best,
    GJ

  6. #6
    Broken Doll,

    SCI-Nurse just pointed out your posts to my attention. I have read your other posts and wanted to start by answering your questions here.

    Hypotension to the levels of 58/32 are worrisome if they are prolonged but the likelihood of a stroke or myocardial infarct is probably self-limited because such low pressures should activate pressure sensing neurons from the brainstem to release norepinephrine, the reason why you are getting hypertensive responses of 168/153 afterward.

    Normally, when you go from recumbent to sitting or standing, the paravertebral sympathetic ganglia along your spinal column should activate vasoconstriction in your belly and legs to push blood back into your central circulation. When most of your blood pool into your legs and belly, there is simply not enough blood for your heart to pump into the arms and brain.

    I am surprised that your doctors will not believe these episodes because they are fairly common. I don't think that you need to worry about the elasticity of your blood vessels.

    Wise.



    Quote Originally Posted by Broken Doll View Post
    I need to find a specialist, specifically someone familiar with spinal cord injury and blood pressure. I need to figure out how to stop extreme high and low blood pressure fluctuations. I'm also worried about efect these severe changes do to the elastisity of the blood vessels and the risk to heart disease.

    The doctors at my local hospital won't believe me when I tell them that my blood pressure was less then 58/32 diastolic before I got out of bed and then a few hours later in my chair, it was 168/153. I've never come close to that reading before and was pretty shaky.

    Yesterday, the ER doctor smirked at me and said it was physiologically impossible and that I would have died. He also ignored my documents I brought to him describing autonomic dysreflexia. He said myBP machine was inaccurate. But we calibrated it and, checked my caregivers BP that was correct.

    While it didn't go as high at the ER, it was high and low enough for him to finally see that I wasn't making it up. Of course, he blamed their BP machines as being defective and had to try a couple of them for verification.

    With those readings, I don't understand why I'm not dead either. I want to protect myself from suffering a stroke or heart attack.

    So I'm wondering if spinal cord injury blood pressure isn't the same as others. It doesn't stay long at that level. It decreases within five minutes. Nonetheless , I wonder if any elasticity damage is done to blood vessels and arteries from all the pressure changes to increase risk for heart disease

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