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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29034
Experience:  MD
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If you are having dizziness, have a history of low blood pressure,

Customer Question

If you are having dizziness, have a history of low blood pressure, your nail-beds on both hands are purplish (bruised looking), your right ankle is swollen, and your nail-bed on your right great toe is purplish in color what could cause this? I have had an echocardiogram which was normal, and tons of blood work and they cannot find out what is going on as my blood work was normal as well. My doctor has ruled out blood clots and infections. What should be my next step? I have also had some heart palpitations which I have never had before..(maybe due to anxiety?). One of the doctor's who saw me said he had never seen anything like it in his 20's year of practice..(meaning the color of my nail-beds and the ankle swelling). Please help.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Hi there,
This is Dr Basu, Experienced Specialist.
I am here to address your concerns and provide great service.
These symptoms are indeed not that common.
That means we need delve into elsewhere to find the possible reason.
Most important one is autoimmune disorder.
Vasculitis or inflammation of the blood vessels can cause low blood pressure, and also purplish discoloration of the hands.
Raynaud's phenomenon, CREST syndrome, Polyarteritis nodosa, or small vessel vasculitis for examples.
Ideally, a biopsy of the nailbed will be helpful.
Blood tests to look for autoantibodies should be ordered --ANA titers, ANCAs, anti Jo1, anti RNP antibodies etc.
Also a digital angiogram to look for vessel inflammation.
Next possibility can be endocrinal problem.
1. Adrenal gland insufficiency
2. Hypoaldosteronism
First you should consult with a rheumatologist and a vascular surgeon.
Thank you for sharing your concerns with us today. If you have any additional questions or need further clarifications, please do not hesitate to ask. I am here to answer them. I wish you good health. Regards, ***** *****