PM for Bradycardia, exhaustion, mental fog
I'm hoping to get some advice regarding my bradycardia. A little background...
I'm 50-yrs old, 5'6", about 135 lbs. All my life, my HR has been a bit on the low side, but was chalked up to me being a competitive swimmer. I'm no longer what you would call an "elite" athlete by any means. I did swim in the summer, and would swim about 3x/week (about 2 miles per swim). However, I don't swim any other time of year. I try to go for walks when I can, but being a busy mom and working F/T, that's all I have time for.
The past few years, I've had extreme fatigue, mental fog, and have even slurred. After a host of tests (including thyroid, which was normal), I had a brain MRI. It showed mild ischemia, but that was all. I also had a stress test (I failed), but I passed the nuclear stress test. I had a sleep study last month, too. No sleep apena, so the neurologist thinks it's due to my low HR. The only thing that has been consistent has been a low HR and BP. A 24-hr holter monitor showed my HR in the low 30's at night (even as low as 28 for 1/2 hr), with an average HR around 50. The only time it gets up in the 60's or higher is if I have caffeine. The echo just showed mild regurgitation for mitral valve and tricuspid valve, which the cardiologist said is nothing to worry about.
In wearing my iwatch, I started keeping track of when I feel better vs when I'm in bad shape. When my HR hits the 60's, I feel much better. But sitting at my desk, or watching tv at night, I tend to hover around 42-44. I notice I have a very hard time thinking clearly, speaking, and just functioning normally. I'm exhausted and finding it hard to follow converations, do simple things like type an email, and not feel completely spaced-out. I experience fluttering/skipping frequently, despite me being relaxed or even sleeping. My hands also are often blue-ish purple (NOT Reynaud's Syndrome as they never get white... just very blue, and sometimes it's during or immediately after excercising).
The first cardiologist I saw told me to just increase my salt intake for hypotension, and that was it. The second cardiologist said, "If you were 70, I'd give you a pacemaker tomorrow, but since you're only 50, I'm hesistant." I had a tilt table test when I was 30 (so almost 20 yrs ago), which I failed so badly they had to give me atropine to get my heart rate back up. I was diagnosed with vaso-vagal caridac syncope, but the only thing I was advised to do was to stay hydrated and again, increase my salt intake. No fainting spells, though I've come close many times.
I started to just give up, feeling like I sound like a hypochrondriac. But the neurologist who did the sleep study thinks I'm not getting enough blood flow, especially at night, which in his opinion is contributing to the extreme fatigue. He thinks I need a PM, but he's not a cardiologist and admitted it's not his area of expertise.
I'm feeling hopeless. I feel like I've been sleeping my life away and no one wants to do anything, writing me up as being "in good shape, so I shouldn't worry." I can't imagine living like this for the next 20 years! I don't know if this makes sense, but have you ever been so tired, it's almost painful? That's where I'm at right now. I have to resort to taking 100mg of caffiene just to get my HR up and so I can function!
I'd greatly value any feedback as I'm just feeling discouraged and lost about what to do, if anything at all, at this point. Should I seek a third opinion?
Thanks in advance - I'm eagerly awaiting this wonderful group's replies and advice.