Heart Rate/Blood Pressure Question

[4tloml]

Has anyone experienced widely fluctuating heart rates and blood pressure even as O2 readings remain stable? Do you know what it may indicate (if anything)?

My PALS's heart rate jumps around from the 50s to the 120s and seems inconsistent with fluctuating blood pressure. (Sometimes BP readings are high when heart rate is high, other times when heart rate is low--same with low BP readings.) He is on Trilogy 24/7 and is either in his recliner or in bed. I had thought maybe BP/HR was reflecting pain, but he denies pain whenever asked.

 

[lgelb]

Heart rate and BP don't have to track. For example, when BP is low, heart can beat faster to compensate. There are a lot of things instability in both can reflect, like energy reserves, CO2 retention, hydration, work of breathing and movement. Whether fed real food or formula, with less mobility/metabolic changes in ALS we don't fully understand yet, there is often more sensitivity to simple sugars, sodium, even bigger vs. smaller meals.

You might consider a "food/liquid/activity diary" to sleuth possible patterns, if the fluctuations bother him. If they don't, I would probably focus on other things.

 

[TomSanti]

I have never had the same blood pressure/heart rate test result twice in a row my entire life. I attribute it to "white coat syndrome" and I never shut up while they are taking the tests.

Sorry that probably isn't much help, but it's my story and I'm sticking to it. (In other words, I don't think it's much to worry about)

Good luck and God bless,


Tom

 

[Atsugi]

My BP and HR often don't correlate to each other. But it is possible that it means something to a PALS. Best see a doc.

On the other hand, if your DH is in hospice, it might really be a waste of time attempting to fix hi BP or low HR. No sense going through the stress and pain of a doctor's visit.

 

[Nikki J]

Are you checking the numbers manually? Especially the pulse? I have a benign slightly irregular heart rhythm and the numbers on the automated machines often alarm the medical assistants who are taking vitals at clinic. However my real pulse is always fine

 

[KarenNWendyn]

Heart rate and blood pressure don't always track together. Either or both certainly can be affected by pain but also arterial oxygen and CO2 levels and by respiratory secretions. E.g. Mucus plugging is the airways is notorious for raising heart rate and sometimes blood pressure. If a person is primarily bed-bound, then physical activity such as with transferring or bathing can also raise heart rate and BP. Going from a reclining to a standing position (for a bed-bound person) can raise heart rate and raise or lower BP. If they're dehydrated, rise in heart rate can be profound and BP can drop.

Hope this helps.

 

[ShiftKicker]

I have the same sort of issues with regards to my heart rate and bp. I was told by an internist that I have some sort of autonomic dysfunction- a neurological glitch that causes dysregulation of heart function and bp, amongst other things. It is in no way affected by diet, activity level or anything that I do- totally random. I have no idea if it's a part of my MND or if it's completely unrelated.

It sounds like you are tracking bp and heart rate in a very methodical and detailed manner- have you shown it to your husband's doctor? They might have some input or desire to explore things further if there is concern.

 

[KarenNWendyn]

Shiftkicker makes a good point about autonomic insufficiency. While not typically a feature of motor neuron disease, there is a subset known as ALS-plus syndrome which can involve autonomic insufficiency. It can also be seen as a separate problem. Also as Tom and others noted, BP and heart rate normally vary quite a bit throughout the day. Some of this has to do with normal daily fluctuations in cortisol levels, but activity, meals, and respiratory changes also affect numbers. Keeping a journal may be helpful.

 

[4tloml]

Thank you everyone for your input.

I do track vitals regularly and have it logged. Sounds like it's not anything urgent (thank you for sharing your own experience, ShiftKicker), so I'll bring the log to his next appointment. (And I'll get back-up manual numbers, Nikki--thanks for heads up on that one.)

He gets meds and feedings at the same time every day--a combination of food smoothies and formula, and he gets 128 oz of water through the tube each day on a schedule. Like Laurie and KarenNWendyn said, though, with all the metabolic changes ALS causes, extra sensitivities to virtually anything external or internal could affect his vitals. I'll quit perseverating on it now. Thanks again!