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hersheydoc
hersheydoc, Doctor
Category: Medical
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Experience:  Medical Doctor
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My blood pressure was 180 over 90. My daughter who is a RN

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My blood pressure was 180 over 90. My daughter who is a RN was very scared and told me that I could have a heart attack or stroke and that I should have been rushed in for an IV and meds to reduce the pressure. My doctor (Cardiologist overseas) was not overly concerned. I need another opinion, please!<br/><br/>My BP was usually anywhere between 120/60 - 150/68, since November it has been reading in the mid 80's for diastolic. Last visit was the one that was 180/90, I saw my cardio on Wednesday, then on Thursday I got violently ill... vomiting continuously (but only while I was moving around... being taken to the hospital and then going to the bathroom... not while lying down) I was very hot, sweating profusely, some pressure at my temples, and very dizzy and lightheaded. They immediately did an EKG and blood work and both were said to be perfectly normal. They determined after overnight stay with constant IV that it was food poisoning. My daughter feels that was too coincidental and thinks I had a mild heart attack (had one tiny shot of tightness in my chest while this was happening, but no other pain at all). She said that the EKG and bloodwork could have been done too soon to show, and that she would be doing new EKG's every few hours if I had been her patient. Is she being overly dramatic, or is my doctor being under concerned?
Submitted: 3 years ago.
Category: Medical
Expert:  hersheydoc replied 3 years ago.

hersheydoc :

I agree that this blood pressure is very high. Heart attack and stroke are definitely possibilities. I think that you need to get additional medications or have the norvasc increased soon. Does this require an emergency room visit, that is up to you. They could get you blood pressure medications and then you could follow up with your PCP or cardiologist. On the flip side many people walk around everyday with blood pressure that high. What is your risk of having a stroke or heart attack in the next day, week, month, that is hard to say. But if the BP isnt lowered soon you will develop problems. How much norvasc are you on? You could possibly increase that med if you arent at the highest dose but that is not something I can recommend , you would absolutely need to talk with the prescribing doctor before doing that. Hope this helps.


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Customer:

I have provided additional information

Customer:

I did not immediately provide you with the additional info. But I am a little disappointed that the live chat is not a live chat. I would expect that as the directions said, I could ask as much as I needed to get my answer until I was satisfied. I will be happy to accept if you could please read my question again and provide an answer. Or maybe I am not aware of how this is supposed to work. Please contact me by email to let me know. Thank you.

Customer:

hello... thank you for entering chat

hersheydoc :

hi

hersheydoc :

please give me a second to read info

Customer:

I'm sorry that I did not provide the rest of that info before... it was one of my main reasons for asking the question to begin with

hersheydoc :

ok

hersheydoc :

did you spend a night in the hospital?

Customer:

yes

hersheydoc :

and if so did they do bloodwork mulitple times while you were there?

Customer:

no.. just when I went to ER

Customer:

no other EKG either

hersheydoc :

So for your doctor to diagnose a heart attack you should have 2 of 3 things. chest pain, EKG changes, and lab abnormalities.

Customer:

no real chest pain.

hersheydoc :

and i would guess no EKG changes

hersheydoc :

that makes it pretty unlikely

Customer:

I don't know what lab work they do, but I have had multiple lab test there over the last 6 monnths

hersheydoc :

i can say that if i was seeing you in the hospital i probably would have repeated one EKG and done 3 lab tests looking for troponin (something released from the hear) after a heart attack

hersheydoc :

the reason would be because of your blood pressure , that would have been my main concern.

Customer:

if I go see my cardiologist in a few days, can I request he do those tests would it confirm anything?

Customer:

by the time I left the hospital my BP was 148/64

hersheydoc :

its possible that with such a high BP your heart might have been struggling ( the pipes - i.e blood vessels, were so constricted that the heart has to pump against you can develop chest pain, and possibly a mild heart attack)

hersheydoc :

the blood tests at this point would likely be normal

hersheydoc :

EKG as well

Customer:

so no way now to verify?

hersheydoc :

the heart attack could have been brought on (if you even had one) by the blood pressure, if that is controlled you should be fine at least for now.

Customer:

so if it elevates again. I need to be more aggressive?

hersheydoc :

I would recommend getting a stress test, either with a treadmill or if you have trouble walking then can stimulate the heart with a medicine to see if you have EKG changes, chest pain, etc

hersheydoc :

yes, treating BP is very important

Customer:

hopefully the norvasc will keep it under controll

hersheydoc :

and it may have been elevated greater than normal because you were sick (GI bug) or in pain

hersheydoc :

do you ever get chest pain, shortness of breath when walking or exercising?

Customer:

Ah.. I had not thought of that. I am still a little bit light headed and slight nausea at times. but not bed, no vomiting anymore

Customer:

no I don't.. I have had bilateral TKR that never healed properly, had in 2007 and still problems, so walking is hard to do

hersheydoc :

so no strenuous activity either to really push yourself to see if those things would develop

hersheydoc :

you would likely need a chemical stress test

Customer:

when I walk or do any exercise I get shortness of breath.. but due to no conditioning... and overweight

hersheydoc :

why do you have a cardiologist in the first place?

hersheydoc :

that makes the picture harder to interpret

Customer:

just got one after having the high blood pressure when I saw another doctor, he referred me

hersheydoc :

maybe just another reason to be looked at closely

Customer:

the weight?

hersheydoc :

i agree with your daughter, this is something to get checked out

Customer:

you mean by getting the stress test?

hersheydoc :

oh no, the shortness of breath with exercise, because you think its from deconditioning but it might not be

Customer:

ah.. ok..

hersheydoc :

i cant tell and i would argue that you cant know for sure either

Customer:

that is true

hersheydoc :

it is likely deconditioning but a small percent of people like you who think thats the problem find out they have a heart problem

hersheydoc :

and when that gets fixed symptoms improe

hersheydoc :

improve

Customer:

well, thank you

Customer:

I think you have answered all my questions and I appreciate that you were there to talk.

hersheydoc :

no problem, hopefully things work out well

hersheydoc :

we go in and out

hersheydoc :

but if you leave the question in the future

Customer:

I will hit the accept bitton and I thank you again

hersheydoc :

someone will answer usually within an hour or definitely a day

hersheydoc :

thanks. bye.

Customer:

bye

hersheydoc, Doctor
Category: Medical
Satisfied Customers: 133
Experience: Medical Doctor
hersheydoc and 6 other Medical Specialists are ready to help you

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