Symptoms of dysautonomia: Chest pain, heart palpitations, sweating, orthostatic discomfort, dizziness

Malfunction of the Autonomic Nervous System

Dysautonomia is an umbrella term used to describe several different medical conditions that cause a malfunction of the Autonomic Nervous System. The Autonomic Nervous System controls the "automatic" functions of the body that we do not consciously think about, such as heart rate, blood pressure, digestion, dilation and constriction of the pupils of the eye, kidney function, and temperature control. 

Sources:  
Post-Covid recommendations for primary care physicians – Switzerland  
Practical management of post-Covid19 disease, Dr Ioannis Kokkinakis, Dr Mathieu Saubade, Dr Konstantinos Tzartzas, Dr Serge De Vallière, Dr Catherine Duquenne, Pr Gilles Allali, Dr Frédéric Regamey and Pr Bernard Favrat - Rev Med Suisse 2023 

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    • Chest tightness 

    • Respiratory dysfunction  

    • Feeling like you need to force yourself to breathe deeply 

    • Rapid breathing (tachypnoea) or heart rate (palpitations) 

    • Wheezing or stridor (noisy breathing) 

    • Abnormally fast or slow heart rate 

    • Postural orthostatic tachycardia syndrome (POTS) 

    • Anxiety 

    • Emotional hypersensibility 

    • Excessive sweating or not being able to sweat 

    • Thermoregulatory sensations troubles 

    • Fatigue 

    • Digestive trouble (irritable bowel syndrome)

  • Simple actions to begin, that you can do right now   

    • Daily resonance breathing 5 min 3 x/day

    • Daily mindfulness meditation 10 min 1 ×/day 

    • Daily adapted physical activity 

    • Daily dynamic stretching exercise of the body  

    • Daily cold showers 

    • Optimal hydration 

     

    Additional actions to go further:
    (Actions stimulation the parasympathetic system) 

    • Vagus nerve stimulation 2x 30 min/day (25Hz)  

    • Regular cryotherapy (chamber or in lake or ocean) 

    • Daily yoga 

    • Complementary medicine approaches (acupuncture, hypnosis, reflexology, etc.) 

    • Medical massages

    • Neurological assessment 

    • Cardiological assessment 

    • Physiotherapy prescription respecting pacing of activities 

    • Occupational therapy 

    • In case of POTS: increase daily salt intake, compression stockings, specific medication 

    Tests:

    • Shellong test 

    • Synacthen test if clinically compatible (hyponatremia, hyperkalaemia) 

    • Tilt test, Holter, cardiological workup  

    • Nijmegen questionnaire  

    • Analysis of heart rate variability

  •  Respiratory physiotherapy 

    • Weekly physiotherapy for adapted physical therapy with respect for pacing  

    • Heart rate monitoring: your physiotherapist can teach you how to take your heart rate. Then, take your heart rate every morning before getting out of bed. Keeping your heart rate within 15 beats per minute of your weekly average should reduce the risk of PESE 

    • Occupational therapy (ergotherapy) can be very helpful in adapting and managing daily life and the impact on work, self-management education etc.

Find out what has worked for others experiencing your symptoms.

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