Quick background:
I am a 25 year old male who has been struggling with panic disorder, health anxiety and heart related issues for the past two years. Been through CBT, was on Sertraline but now doing much better with the anxiety and panic but left with very persistent and disabling physical symptoms. These include - vagal responses and breathlessness with slow thumping, often painful, beats that ramp up to tachycardia upon standing from a seated position, climbing stairs, bending down, etc. Also, I have particularly bad tachy in the morning and feel terrible after a shower. I am currently on 10mg of Propranolol just to take the edge off the painful palpitations.
Recently, the possibility of POTS and/or Chronic Fatigue has come up when seeing my GP and it would certainly explain the morning tachy, reaction to standing and stairs, crashes after shower.
However, unlike what seems to be common in these conditions, my reaction to standing is transient and lasts 30 seconds and then passes. As far as I can tell, it does not get worse the longer I stand and in fact, only a couple of weeks ago, I was able to go for a 6 mile walk with no energy crash other than the usual fatigue and dizziness that I have associated with anxiety all of my life.
However, in researching POTS I have found that a common identifier is low blood volume and narrow pulse pressure (top number minus the bottom number of your blood pressure reading). I have been keeping an eye on mine for the last few days (Yeah, yeah. Checking behaviour!) and have noticed that my pulse pressure is definitely lower than the "normal" 40mmHg. After a shower and when I'm feeling particularly naff it can drop as low as 15.
What makes this curious is that when I checked notes that I made for a GP appointment 6 months ago and had taken a few BP reading at home, my pulse pressure was a very consistent and normal 40.
Why has this changed in the last 6 months when I have been having symptoms for over 2 years? Should I be concerned? Has anybody else here observed low pulse pressure in their readings?
I'm due to have more cardiology investigations in a few months and I am really hoping not to be diagnosed with POTS or any kind of Dysautonomia, as it seems so daunting and insurmountable to me. At least when this was all just anxiety and panic, there was light at the end of the tunnel.
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