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My 94 year old mother has blood pressure readings that

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My 94 year old...

My 94 year old mother has blood pressure readings that fluctuate between - extremely high and extremely low each day. She started having some chest pains and went to emergency room; a pacemaker was inserted. She is on low dose Lisinopril and baby aspirin plus thyroid medication for hypothyroidism. In hospital, she had lots of tests, including echo which showed she ha'd a 'great' heart.Since the hospital visit she continues to have blood pressure issues and is often dizzy and lethargic. In the past, she was shown to have had several TMIs. In follow up to her hospital visit for her heart issues, the doc now wants to do a chemical stress test. We are concerned that this will "do her in." If she does have the test, if it shows she needs surgical intervention, is this wise for someone her age? What are our options. We certainly want to make sure docs have info they need to provide the best care but we feel she is fragile and don't want to risk her life.

Doctor's Assistant: Do you know if your family has a history of heart disease? In general, how would you describe your health lately?

This pertains to my mother. See above regarding blood pressure readings, etc. I do know that there is stroke in family history; possibly heart issues but I don't have specifics.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

See above for relevant info

Submitted: 10 months ago.Category: Cardiology
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Answered in 5 minutes by:
9/26/2017
Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago
Dr. Arun Phophalia
Category: Cardiology
Satisfied Customers: 39,120
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago

Do you mean that doctors are contemplating a pharmacological stress test; in which a medicine is injected to see the heart blood flow?

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Customer reply replied 10 months ago
that is my understanding
Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago

The test has some risk for her age group, but if this is done under very good medical supervision, risk of untoward consequence can be brought down to almost 1% or less for geriatric population.

The medication does not increase the heart rate. The medication dilates blood vessels of the heart, increasing blood flow, therefore simulating exercise as geriatric patients are unable to exercise on a treadmill.

It gives a very good account of the coronary arteries and blood flow to the heart muscles (myocardium).

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 10 months ago
What types of interventions are typically recommended if the stress test shows issues with the arteries? Is a surgical intervention (such as placement of a stent) recommended? If yes, isn't this risky for someone frail and aged 94?
Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago

Yes, the stent may be recommended but many times only medicines are needed. Medicines too can have adverse effects in her age group.

Stenting has inherent risks also for her age.

This is weighing the pros and cons. On one side there is a huge fluctuation of blood pressure and on other side the risks of procedures or medication. I completely understand your view point and it is a very difficult decision making. So you need to discuss both the aspects with your doctor and between your family members.

Personally I avoid too much interventions for this age group if the quality of life is reasonable.

It is privilege assisting you.

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Customer reply replied 10 months ago
Thank you
Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago

You are very welcome.

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Cardiologist: Dr. Arun Phophalia, Doctor replied 10 months ago

Just Answer is based on honor system. Experts are paid for time and expertise only when a positive rating is received.

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