Need help - HR 115 BP 60/40 feel like death is upon me.

I would definitely get a second opinion. With a blood pressure that low you could pass out and seriously injure yourself. I believe additional testing should be done. Hope you get the answers you need as to why this happening and you feel well soon

Fifteen years ago, I was hospitalized for ten days while they tried to figure out why I had developed extreme orthostatic hypotension (even lower than yours. I had spent three days in and out of consciousness on the floor of my living room unable even to stand to get to the phone for help). Had also fallen down the stairs more than once. When I finally got to the ER they even had trouble reading my BP.

By the end of that period of intermittent unconsciousness, of course I WAS dehydrated but that had nothing to do with the cause of my problem. I felt fine reclining (normal BP). but as soon as I tried to stand, I blacked out immediately (In the hospital, I was forbidden to stand.). Standing (with support - on both sides), also led to tachycardia. (Do YOU have tachycardia upon standing?). It was a terrible experience especially because I was mistreated in the hospital. They even tried to discharge me without a diagnosis!

I should have been diagnosed within minutes in the ER because it turned out my condition was the result of a new medicine (Nardil , an MAO inhibitor antidepressant) which , with the permission of my psychiatrist, I was gradually titrated up as needed. I guess the most recent 15 mg titration pushed me over the edge of getting this known side effect. One of the most basic question supposed to be asked (and checked) in the ER is what meds the patient is taking and whether any are new. (If so, they are to check whether it has any known side effects corresponding to the the patient's presenting symptom - for me orthostatic hypotension.). Dumb dumb dumb!! Their failure to follow ER protocol cost me $30K, and ten agonizing days of neglect and rudeness, until it dawned on someone to link it to that medicine.

In any case, I've taken this opportunity to complain about one of my all-time worst medical experiences (sorry for what may be boring) which I'm describing because it's a good example of what can cause your symptom. I was checked to rule out many other causes (EXCLUDING linkage to my meds!). It is infuriating that they are writing you off without adequate investigation. About your stomach pain, I don't know (unless you have internal bleeding there as blood loss can also cause low BP.) Do you have the low BP at particular times - for example, upon standing? Have you ever passed out? We really have to advocate for ourselves. Try not to panic, but DO persevere in insisting on a thorough evaluation.

(My treatment was discontinuing the causative medicine and being prescribed Florinef - a medicine that caused salt retention to deal with the dehydration (even though it was caused by that period without fluids.)

Wishing you all the best in arriving at a diagnosis and treatment.

See a neurologist

Hello @rickfox2676, I would like to add my welcome to Connect along with @lmurray03 other members. I agree with @lmurray03 about getting a second opinion. Mayo Clinic has some information here - Low blood pressure (hypotension): https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465

You mentioned you also have pain in the abdomen but the ultrasound was normal. Here is an article that sounds similar to what you are describing.
"Can low blood pressure cause abdominal pain? -- If you feel abdominal pain and dizziness after eating, it may be because your blood pressure hasn't stabilized. This sudden drop in blood pressure after a meal is called postprandial hypotension. Normally, when you eat, blood flow increases to your stomach and small intestine." --- What's Causing My Abdominal Pain and Dizziness? - Healthline: https://www.healthline.com/health/abdominal-pain-and-dizziness

Have you thought about getting a second opinion or seeking help at a major teaching hospital or health facility like Mayo Clinic?

First I'd get a second opinion from a well known facility like Mayo or Cleveland Clinics or a large teaching university. Even if you have to travel, I'd urge you to do it. The way you were treated is unacceptable and I'd also be talking to a malpractice lawyer. I don't believe in suing because your coffee was or wasn't too hot, but when it comes to our lives, we deserve the very highest level of care. I wish you luck and an answer to your medical issues.

Hi rickfox2676,
I am sorry to hear you are having difficulties with your blood pressure and heart rate. I have several complex heart conditions - arrhythmias, aortic aneurysm, hypoxia, borderline pulmonary hypertension - and my local team of specialists across multiple disciplines did not take my symptoms seriously. I felt like I was dying at home for the past year - on oxygen, fatigue, chest pain, high and low heart rate and blood pressure, and near fainting episodes. My vitals signs were always normal at my clinic visits. I purchased an Apple Watch, Omron Connect wrist blood pressure monitor with bluetooth, Lookee Sleep Pro and Nonin Connect oximeters. All this data goes directly to my phone and I can print out reports to show my specialists or simply show them my phone app readings. I highly recommend collecting home data and going to Mayo Clinic for an evaluation. I recently traveled to Mayo in Jan and Feb for evaluations, and the amazing Mayo Cardiology team did thorough testing and diagnosed me heart failure (HFPEF) after doing a right heart cath. This explains some of my symptoms. I also had my first big episode of AFib there, and I am now on medications. I feel better and my chest pain is gone. Please don’t give up hope. Collect data at home and seek out expert advice. My original Medicare and Medigap policies covered most of the extensive evaluations across specialties. I will return each year to Mayo for follow up. Best of luck to you. I hope you will get feeling better soon.

I would like to thank everyone that took time to respond to my plea for help. To add further. My BP is dropping daily and stays around the 70/50 range. I've cut out all meds to make sure there were no interactions. The doctor prescribed Midodrine to raise my BP as so I don't black out or die but it only raises BP a few points. I am a severe diabetic but my diabetes has never caused BP issues. A HIDA Scan was performed but no results. I feel descent if sitting or lying down, feel like death is upon me when standing. Lose my breath, go black and slur speech. I was told possible Addison's Disease or Bile duct obstruction but no blood work or testing done.

Have you tried adding extra salt and/or Florinef?
(Just for the record, you don't just have low blood pressure, it sounds like you have orthostatic hypotension - as I did). Does your pulse also race when you stand?

Thank you Janet for your concern, very sweet! I had a heart catheterization in 2019 and 2 stints placed. I'm previously a heart attack survivor 3 times over. I feel not chest pain or symptoms of heart failure. Just the drop in BP w/ abdominal pain, dizziness, and I do have neck pain. I had partial amputation of right foot in June 2019 and kept infection needing IV therapy in October 2019. Never checked to see if infection was gone. Was told possible sepsis still but no testing ordered. Very concerned about my health with no concern from doctors. I am a dad of 4 girls and 2 grandchildren, I want to live.

Hi Rickfox2676 I can totally understand your concerns. I have suffered from low BP upon standing, walking and most anyother natural movements. Two events occurred, that my BP would not show on the BP cuff, resulting in ER visits. I have had syncope spells and near blackouts while golfing, walking, picking up trash and even while driving. Many times, I visited the VA Hospital and was told everyone's BP falls upon standing but your's is much more profound than average. Finally I resided in the hospital for a week and decided that Afib was the primary cause and I had a re-conversion. Even after that process after being put on Beta blockers and Blood thinners, I still suffer from this. I have had to quit playing Golf, Driving, or any sport or exercise where even fast eye movement is necessary. I have been fortunate, for I have fallen many times, but have not really injured myself. This has occurred the last 15 yrs of my life. I have been seeing an Endo Dr for about seven yrs and have been prescribed Cortisol off and on. Every Cortisol test shows borderline?? levels in my blood and my PTH level last test was 145 and the Dr said it should be watched??? Several of my Chemicals are out of balance and I have a blood test every 3 months. I get so frustrated when the Dr says I am a complicated case. I know that death feeling and it is no FUN. I wish you all the best and may your Dr determine some explanation!!!!