Could My Symptoms Indicate Autonomic Nervous System Dysfunction?

Could my symptoms be due to autonomic nervous system dysfunction?

Hello doctor, my heart rate is relatively slow (around 55 bpm) and my blood pressure is also low.
Recently, I have been experiencing severe palpitations that can last up to four hours.
After meals, I often feel my heart beating particularly hard.
Throughout the day, I frequently notice my heartbeat.
A few months ago, I experienced what seemed like panic attacks (uncontrollable shaking, shortness of breath, feeling like someone was watching me).
I also tend to have sweaty palms and hand tremors.
When I stand up, my vision goes black, and I easily experience shoulder shrugging and stiffness in my neck and shoulders.
Should I seek further medical evaluation?

Ts, 10~19 year old female. Ask Date: 2021/02/23

Dr. He Dongjin reply Cardiology

Hello, your symptoms indicate autonomic nervous system dysfunction.
It is recommended to seek further medical attention and consider medication.
Ping An Changhua Hospital cares about you.

Reply Date: 2021/02/23

More Info

Your symptoms indeed suggest a potential dysfunction of the autonomic nervous system (ANS). The ANS is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, digestion, and respiratory rate. When the ANS is not functioning properly, it can lead to a variety of symptoms, which you seem to be experiencing.

1. Heart Rate and Blood Pressure: You mentioned having a slow heart rate (around 55 beats per minute) and low blood pressure, which can be indicative of autonomic dysfunction. A heart rate that is too slow (bradycardia) can lead to insufficient blood flow to the brain and other organs, causing symptoms like dizziness or fainting, especially when standing up quickly (orthostatic hypotension). The episodes of severe palpitations after meals could be related to postprandial hypotension, where blood pressure drops after eating, leading to compensatory increases in heart rate.

2. Panic Symptoms: The panic-like symptoms you described, such as uncontrollable shaking, difficulty breathing, and a feeling of being watched, can also be linked to autonomic dysfunction. The ANS has two branches: the sympathetic nervous system (which prepares the body for 'fight or flight' responses) and the parasympathetic nervous system (which promotes 'rest and digest' functions). An imbalance between these systems can lead to anxiety and panic attacks.

3. Sweating and Tremors: The excessive sweating and hand tremors you experience may be due to hyperactivity of the sympathetic nervous system. This can occur in conditions like anxiety disorders or other forms of autonomic dysregulation.

4. Neck and Shoulder Tension: The stiffness in your shoulders and neck could be a physical manifestation of stress or anxiety, which often accompanies autonomic dysfunction. Chronic muscle tension can further exacerbate feelings of discomfort and anxiety.

Given these symptoms, it is crucial to seek further medical evaluation. Here are some steps you might consider:
- Consult a Specialist: A visit to a neurologist or a cardiologist who specializes in autonomic disorders would be beneficial. They can perform specific tests, such as a tilt table test, to assess how your body responds to changes in position and to evaluate your autonomic function.

- Holter Monitor: Wearing a Holter monitor for 24-48 hours can help capture your heart rate and rhythm during your daily activities, providing insight into any irregularities that may be occurring.

- Blood Tests: Comprehensive blood tests can rule out other potential causes of your symptoms, such as thyroid dysfunction or electrolyte imbalances.

- Lifestyle Modifications: In the meantime, consider lifestyle changes that can help manage your symptoms. Staying hydrated, avoiding excessive caffeine or alcohol, and practicing stress-reduction techniques such as mindfulness or yoga may be beneficial.

- Physical Therapy: If muscle tension is a significant issue, physical therapy may help alleviate some of the discomfort in your neck and shoulders.

In conclusion, your symptoms are concerning and warrant further investigation. Autonomic nervous system dysfunction can significantly impact your quality of life, and addressing it early can lead to better management and improvement of your symptoms. Please do not hesitate to seek medical attention to explore these issues further.

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