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High BP chest discomfort - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
Doctor :  
How can I help you?
User :   Hi, Suddenly one morning I started having vertigo in certain positions of head(on looking up, on going down to bed, changing position in bed). Doctor said that I am suffering from Cervical Spondylosis and asked me to do some exercises and heating therapy. I did that and after 2 weeks, vertigo was gone, but still I had vertigo sensation and heavy headedness in those position for a momentary seconds. Then for next 2 month nothing improved. I again went to Physician and my BP came out to be 145/98. He gave medication(Ciplar LA 1 BD) and I underwent BLood Tests, Urine tests, Ultrasounds as my age is 24 and doctor said there should be definitely a cause for hypertension. Later it was found that I had kidney infection(protein high) and have only one kidney by birth. Later with antibiotic, infection was gone and Blood Tests/Urine tests done after antibiotic duration came out normal. My Bp was measured and it came to 126/87. Doctor said single kidney is cause of hypertension in my case and he added Telma-40 1OD in addition to Ciplar LA BD. Then for next 2 weeks, Bp was under control and even reduced to 100/60. Sometimes it went down to 55 as well. I thought doctor would reduce the medication now but he didn't. So I went to another doctor and he gave me new med Amtas-5mg and old ones were put off. Then for next 2 days Bp was around 110/70-120/80. On third day suddenly BP shot upto 155/98 and I took some med at that point. Since then with Amtas-5mg, my BP remains 120/80-140/90. 140/90 when it becomes around 24rs since the last dose.
User :   But the question that I wanted to ask was that after taking Amtas-5mg, my BP came down to 140/80 from 155/98 in just 15-20 mins. Even when it is 140/90, it came down to 123/80 in just 10-15 mins. Does it mean that Amtas-5 acts immediately on BP to reduce it or its that after taking med, I feel relaxed and loss of anxiety brings the BP down cause I feel that all the meds/tablets takes atleast half an hour to start their action. But since last 2 days, my BP remains around 130/80-140/90 and even after taking medicine, it doesn't drop to 110/70 or so. It seems Amtas is not having any effect virtually on me.
Doctor :  
Let me read it
User :   So the questions which I want to ask are: 1. How long does it take for Amtas to start showing its effect. Does it start in 15 mins or later? 2. In case Amtas takes long to show its effect, can the drop in high BP after taking med be related to loss of anxiety and relaxation after taking med? 3. Now I want to go back to Cipla LA 1BD+Telma-40. Is is safe to go back to it? I can't ask doc to revert me to it and he may not do it as its med of some other doctor. 4. Today even after taking Amtas 5mg in morning too, my BP still remains around 130/80 after 2 hrs of taking 2nd dosage, so its virtually no effect at all. 5. For Positional Vertigo, ENT doc has given me LCZ Mont 1OD, Stugeron 1BD. IS it safe to take these medicines with BP medicines? I havnt started on these medicines yet.
User :   ok
Doctor :   Amtas, time for action can start with minimum of 5-10 minutes as well

Doctor :  
So that is not of concern
Doctor :  
but there are some other psychological factors as well
Doctor :  
which does play a role in reducing your BP
Doctor :   That does explain your second question

User :   ok
Doctor :   Coming to your 3rd question

Doctor :  
if you want to revert back
Doctor :  
it is fine,there is no problem
Doctor :  
but you shall need a prescription for the same
Doctor :  
So I would suggest you to go back to your old doctor
Doctor :   for 130/80, it is not a bad reading

Doctor :  
you should stop too much of thoughts on it
Doctor :  
that shall help you to a very good extent
Doctor :  
as you have mentioned it in your second question
User :   I mean i wanted to figure out the cause of high BP. Is it having single kidney or is it anxiety?
Doctor :   Anxiety
Doctor :  
is more likely in your case
User :   but I never had any BP problem till now, and before doctour found out I had high Bp, reading on previous day was 120/80 and reading one month prior to that was 124/84
Doctor :  
as I can get a hint reading your history
Doctor :  
and also your younger age as well
Doctor :   Right

Doctor :  
You can start tapering the BP medications once the reading settles
Doctor :  
and later withdraw it
Doctor :  
need not be taken lifetime
Doctor :  
as the reading is not that high
Doctor :  
the kidney infection
Doctor :  
can spike the BP
Doctor :  
and that is the likely cause at the first instance
Doctor :  
when your BP was high
User :   hmm
Doctor :  
now, with all these, anxiety has chipped in
Doctor :   but there is no problem which I can detect
Doctor :  
with your BP
Doctor :  
So first you should relax
Doctor :  
gradually taper the BP medications with continous monitoring
Doctor :  
and then withdraw
Doctor :  
but do it with doctor's consultation
User :   yeah
User :   so first I have to figure out a med combo which gives me better control of BP and later reduce it to 0 right?
Doctor :  
Right
User :   so having a single kidney shudnt result in hypertension?
Doctor :   Not a problem

User :   because many doc said that my high bp is because of single kidney
Doctor :  
if it is working fine
Doctor :  
You should not think of that now
Doctor :  
Keep your monitoring activity going
Doctor :  
dont have that in mind
User :   when my BP came high, I had kidney infection(Few epithelial cell and Proteins High).
Doctor :  
that a single kidney causes such issues
User :   But doc gave oflin for 10 days, and later results came out fine
User :   I had underwent ECH,Echo, Renal Doppler, Serum Complete Lipid Profile, Urine 24 hr Protein, Urine R/E, Chest X-ray, KUB MRI
Doctor :   Yes I got it

Doctor :  
that you have improved after use of antibiotics
User :   and all came fine other than having single kidney and compensatory hypertrophy in the left kidney
Doctor :   Ok

User :   So I can change to Ciplar LA + Telma in case situation remains same? I have medicines left and old prescription from the old doc
User :   and as I am seeing govt hospital, old doc may get angry/irritated if i tell him that I stopped his medication to try sumthng else
User :   thats why I wanted to revert back to old med myself
Doctor :   Fine

Doctor :  
but you cannot do it without a consultation in person
Doctor :  
and getting a prescription as of now
Doctor :  
You tell your current doc
Doctor :  
about the efficacy of the old medicine
Doctor :  
and he should respond to it
Doctor :  
No problem
User :   hmm
User :   Ok, I will try that
User :   For Positional Vertigo, ENT doc has given me LCZ Mont 1OD, Stugeron 1BD. IS it safe to take these medicines with BP medicines? I havnt started on these medicines yet.
User :   because I saw that LCZ Mont contains sodium
Doctor :  
You can take it
Doctor :  
they are good medications
Doctor :  
the content is very less in tablets
Doctor :   it is negligibile sodium content only
User :   ok
Doctor :  
so no need to think of that
User :   One more, How much my BP can shoot up which shudnt be a cause of worry
User :   cause whenever I see my BP going above 140 or 90, i become worried
Doctor :  
Within 150 mm Hg
Doctor :  
is fine
Doctor :  
and the below one should be within 100
User :   ok.
User :   So even if I have 140/90 continuosly for one week, no reason to worry?
Doctor :   Without medications that reading is fine

Doctor :  
but with medications it is not
User :   So, how much shud be with meds?
Doctor :  
so if it is so, then report back to the treating doctor
Doctor :  
within 130/90
User :   ok
Doctor :  
plus or minus 6
Doctor :  
in both cases
Doctor :  
Is there any thing else I can help you with?
User :   One more thing
Doctor :   Ok
Doctor :  
Proceed with it
User :   AS I said, one morning when I got up from bed, I felt vertigo and few days later I figured out that whenever I look up, or drink water from bottle looking up, or go to bed, or get up or rotate head in bed, or change side in bed, I had vertigo. Small in duration(around 2-3 sec).
User :   ENT doc said its due to cervical, and asked me to avoid those positions and I got a MRI done
User :   in MRI, it came out that I have cervical disk bulge at C4-5, C5-6,C6-7 which on compression gives canal diameter of 9mm resulting in nerve root compression.
User :   Then I had 15 days of SWD
User :   and physiotherapy
Doctor :   Ok

User :   first 15 days, symptoms reduced a bit
User :   and I dint get vertigo
User :   bt in those positions, I feel vertigo like sensation. Like, head feels heavy and then I feel like I am having vertigo but nothing spins and all this for a split second(0.1-0.2sec).
User :   and since then, I continued heating and exercises fr 2 months and nothing improved
Doctor :   Yes that is what is meant by BPPV

Doctor :  
no organic cause
Doctor :   but you shall get it
User :   so I am not suffering from cervical spondylosis?
Doctor :   What did the MRI report tell?

User :   my old doc who gave Ciplar and Telma told me that this canal stenosis is to a very small extent

User :   actually I went yesterday to this new doc, this new doc who gave me Amtas said that mine can be due to cervical
User :   but wasnt sure
Doctor :   An orthopedic surgeon examination and an MRI report shall be conclusive

Doctor :  
but again it is possible both ways
Doctor :  
so if you have or not
Doctor :  
line of treatment remains the same
Doctor :  
the stenosis I remember is not of concern
User :   orthopedic doctor with 30-40 yrs exp told me that its nothing
User :   hmm
Doctor :   Then good enough

User :   one more thing is since my last high BP reading(155/98) 3 days back, I felt ghabrahat(can be described as worrysome state)
User :   since then, it has reduced much but still i can feel slight anxiety still
User :   1 month back i felt the same and felt pressure on heart as well, but after taking a digene med(Aristozyme), it went away
Doctor :   that is in your hands to reduce it

Doctor :  
you should sleep well
User :   but this time it hasnt
Doctor :  
and do certain relaxation breathing
Doctor :  
meaning deep breathing for 20 mins
Doctor :  
2 times per day
Doctor :  
that shall flush your anxiety
User :   ok.. cool
User :   one last thing is LCZ Mont is to be taken 1OD or 1/2 BD?
User :   cause i forgot what doctor said and chemist wasnt able to figure out from the prescription
User :   in audiometry, it came out that I have very mild hearing problem in right ear
Doctor :   It is unethical and unwise for me to amend the prescription

User :   and since 3 days, my pulse remains 90-110. and sometimes goes to 84 on resting? Thats of not any concern?
Doctor :   but it is once daily
User :   ok
Doctor :  
usually
User :   fine, i agree
Doctor :   Is there any thing else I can help you with?

User :   last thing
User :   and since 3 days, my pulse remains 90-110. and sometimes goes to 84 on resting? Thats of not any concern?
Doctor :   I am smiling
Doctor :  
with your anxiousness
Doctor :  
it is bound to fluctuate
User :   :|
User :   yeah, I think i m getting over concerned on health matters
Doctor :  
You should keep your cool
User :   i shud stop doing that
Doctor :  
True
Doctor :  
and stop googling those as well
Doctor :  
it leads to unnecessary panic
User :   yeah, true
User :   thats all i have to ask
User :   thanks for answering all my qs again patiently
User :   :)
Doctor :   Pleasure is min

Doctor :  
'mine
User :   feedback done.
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.

User :   yeah sure
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