Is It Autonomic Nervous System Dysfunction? Your Symptoms

Could this be autonomic nervous system dysfunction?

Hello, Doctor.
I have been experiencing palpitations frequently for about a month.
During this time, I underwent an echocardiogram, which diagnosed me with mild mitral valve prolapse and mild arrhythmia.
The doctor said it was not serious.
I also had a thyroid examination, which showed no abnormalities.
However, I still feel uncomfortable, and my symptoms are as follows: 1.
I noticeably feel chest tightness and an increased heart rate after meals.
2.
When I first lie down to sleep, my heart rate is normal, but I can clearly feel my heartbeat, as if my body is vibrating, and it takes a long time for me to fall asleep.
3.
Just as I am about to fall asleep, I am suddenly awakened by my own heartbeat.
4.
I experience shallow sleep; I wake up suddenly in the middle of the night and then remain in a half-asleep, half-awake state.
5.
I have chronic diarrhea and often feel bloated, with occasional mild nausea.
The doctors have advised me to adjust my lifestyle and not to put too much pressure on myself, but I cannot ignore my physical discomfort.
I would like to ask if I might have a problem with autonomic nervous system dysregulation.
Is there any way to improve this? Thank you, Doctor.
:)

Hai Zi Wang, 20~29 year old female. Ask Date: 2016/01/20

Dr. Gao Chunde reply Neurology

Actually, autonomic nervous system dysfunction is not a true medical diagnosis; it is a result of underlying factors such as stress, anxiety, and irregular sleep patterns.
When the parasympathetic nervous system is supposed to be active during rest and relaxation, inappropriate sympathetic nervous system activity may emerge.
I agree with your physician's statement that if they have prescribed propranolol to help control your arrhythmia symptoms, it may also lead to some improvement in your other symptoms.

Reply Date: 2016/01/20

More Info

Based on your symptoms and the medical evaluations you've undergone, it does seem plausible that you may be experiencing autonomic nervous system (ANS) dysfunction, commonly referred to as dysautonomia. This condition can manifest through a variety of symptoms, many of which you have described, including palpitations, chest discomfort, sleep disturbances, and gastrointestinal issues.

Understanding Your Symptoms
1. Palpitations and Chest Discomfort: The sensation of your heart racing or pounding, especially after meals, can be linked to the autonomic nervous system's regulation of heart rate and blood flow. The heart's response to food intake can vary among individuals, and in some cases, it may lead to increased heart rate and discomfort due to the body's autonomic response to digestion.

2. Sleep Disturbances: The feeling of your heart beating strongly when lying down, along with waking up startled by your heartbeat, suggests heightened sympathetic nervous system activity. This can be exacerbated by anxiety or stress, which can further disrupt sleep patterns, leading to shallow sleep and frequent awakenings.

3. Gastrointestinal Issues: Chronic diarrhea and bloating are also common in individuals with dysautonomia. The autonomic nervous system plays a crucial role in regulating gastrointestinal motility and function. Dysregulation can lead to symptoms like bloating, nausea, and altered bowel habits.

Possible Causes
Dysautonomia can be triggered by various factors, including stress, anxiety, hormonal changes, or even underlying medical conditions. Given your history of mild mitral valve prolapse and arrhythmia, it's essential to consider how these cardiovascular issues might interplay with your autonomic nervous system.

Recommendations for Improvement
1. Lifestyle Modifications: While your doctors have advised lifestyle changes, it's crucial to implement them effectively. Consider the following:
- Diet: Eating smaller, more frequent meals can help manage postprandial symptoms. Avoiding caffeine, alcohol, and high-sugar foods may also reduce palpitations and gastrointestinal discomfort.

- Hydration: Staying well-hydrated can support blood volume and circulation, which may alleviate some symptoms.

- Exercise: Gentle, regular exercise can help improve autonomic regulation. Activities like yoga or tai chi can be particularly beneficial for reducing stress and promoting relaxation.

2. Stress Management: Techniques such as mindfulness, meditation, and deep-breathing exercises can help manage anxiety and stress, which may be exacerbating your symptoms. Cognitive-behavioral therapy (CBT) can also be effective in addressing anxiety-related issues.

3. Sleep Hygiene: Establishing a calming bedtime routine, maintaining a consistent sleep schedule, and creating a comfortable sleep environment can improve sleep quality. Limiting screen time before bed and avoiding heavy meals close to bedtime may also help.

4. Medical Follow-Up: Since your symptoms are persistent, it may be beneficial to follow up with a neurologist or a specialist in autonomic disorders. They can conduct further evaluations, such as tilt table tests or autonomic function tests, to assess your condition more thoroughly.

5. Medication: If lifestyle changes and non-pharmacological interventions do not provide sufficient relief, discussing medication options with your healthcare provider may be warranted. Certain medications can help regulate heart rate and improve gastrointestinal symptoms.

Conclusion
In summary, your symptoms align with autonomic nervous system dysfunction, and while lifestyle changes are essential, a comprehensive approach involving medical follow-up and possibly therapeutic interventions may be necessary. It's important to communicate openly with your healthcare providers about your ongoing discomfort and to explore all available options for managing your symptoms effectively. Remember, you are not alone in this journey, and with the right support and strategies, improvement is possible.

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