During our Annual MSA Support Group Patient/Caregiver Conference in September 2012, it was apparent that a decent number of patients were suffering from low blood pressure symptoms, but had not been diagnosed or treated for the condition. We also frequently hear stories about MSA patients suffering for a few years from lightheadedness and other symptoms before their doctors find the cause.
Do you have the symptoms of low blood pressure when you stand?
Symptoms of low blood pressure can range in severity, from mild lightheadedness after standing to fainting and blacking out. Symptoms can include any combination of dizziness, lightheadedness, blurry vision, head and neck pain, trouble concentrating, feeling faint, blacking out, fainting and frequent falls. Especially because of fainting and falls, symptomatic low blood pressure can lead to injury and disability
Low blood pressure symptoms are often the cause of early disability in multiple system atrophy (MSA) patients. Low blood pressure upon standing, known medically as orthostatic (standing) hypotension (low blood pressure), is a characteristic early sign of MSA. Approximately 80% of MSA patients have orthostatic hypotension (OH). If the low blood pressure is caused by MSA or other neurological disorders it is called neurogenic orthostatic hypotension. However, orthostatic hypotension can also be caused by certain medications, dehydration, and heart problems and these causes need to be ruled out.
If You Have Low Blood Pressure Symptoms
If you feel low blood pressure symptoms you should speak with your doctor and ask to have your blood pressure checked not only while lying down, but also after sitting and then at one and three minutes after standing. If you have a greater than 20 mmHG (millimeters of mercury) drop in systolic blood pressure during the standing test you have orthostatic hypotension and you should discuss treatment options with your physician.
Treatments for Orthostatic Hypotension
Before prescribing a medicine your doctor may recommend life-style modifications, such as:
- Increasing the amount of water you drink
- Adding salt to your diet
- Sleeping with the head of your bed elevated
- Wearing compression stockings
- Exercise or physical counter-maneuvers
- Staying inside on hot days
If life-style modifications do not work or have limited effect, there are two FDA approved treatment for orthostatic hypotension – midodrine and newly approved Northera (droxidopa). There are also other medications that doctors prescribe to help control low blood pressure symptoms that are not indicated for OH.
3+ years of no diagnosis from my cardiologist after: Blood clots in legs which went to lungs/heart causing Afib.
Cardio-version cured the Afib but have left me with crushing fatigue and severe neck pains while standing and doing minor chores like brushing teeth or kneading dough. Almost to the point of passing out.
BP always drops like a rock when these symptoms occur.
Today after kneading dough for 5 min it was 81/47 {heart rate 85} It has been lower like 80/32. Have given up on doctors.
I can walk for 30-45 min without issue. It appears to occur when my head is tilted down. Nerve pinch???????????
Hi Craig,
I am sure you are frustrated – 3+ years is a long time to suffer without a diagnosis. Your blood pressure drop when standing still, like when kneading dough or brushing teeth could be caused by a neurological issue, and it could be that the blood pressure drop is what is causing your neck pain. I suggest you see a neurologist that specializes in autonomic issues for an evaluation.
Craig Whitley did you ever get it figured out? Was it a pinched nerve in your neck? I get similar symptoms specifically when I pinch something in my neck, just below the head. I wonder if it is the dens, i.e. Orthodontic process? hope I got that word right/dens is accurate I believe too.
Try going to an osteopath doctor. You’ll have success.
When i go to bed within 3 minutes going to normal after standing up more than 5 min going like less energy eyes not concentrating on one thing . Fainting dizziness ..
Craig Whitley… was it a nerve pinch in neck? I’m concerned mine might be.
At this page, under the Treatments for O.H., the word “ays” should be “days”.
https://www.multiplesystematrophy.org/blog/low-blood-pressure-symptoms-upon-standing/
Thanks Ann for pointing out the typo!