The pounding will continue the rest of the night keeping me awake.  I have been prescribed .5mg Klonopin and 50mg Trazodone to try to keep me asleep but inevitably my pounding heart will wake me up.  It does not matter if I am on my sides or back.  I had a neg echo x2 but stress test showed evidence of possible ischemia.  My blood pressure runs normal most of the time but had started soaring in the middle of the night up to 180/110.  Now with the meds it has not gone up as high but now I am SOB in morning with activity and experience orthostatic hypotension worse in morning.  I am 47...weigh 142 and exercise regularly but my capacity to exercise has decreased and my pressure has dropped down to 86/60 after exertion.  I am pressing for another stress test as i am not anxious when the heart pounds but I cannot get back to sleep and this concerns me (sleep study reprot did mention arrythmias but not specific).  My heart rate has dipped to 46bpm while sitting down watching tv.  Any ideas? I have already been worked up for a pheo, neg lab test, normal CT of head and chest, normal abdominal MRI.  Stong family hx for heart disease.  I feel like I am getting the blow off becasue they cannot find a reason and just call it anxiety.  When I do feel very anxious, my blood pressure is normal.  When it goes extremly high, my heart rate is normal but heart rate does increase when pressure goes lower.  The just stopped the 2.5 mg Lisinopril yesterday.  I have dropped to 60/40 after being 191/121 with .2mg cholonidine.