Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
198 Doctors are Online

LAP is 15 and BP is fluctuating, had a second ablation for afib - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2244 Questions
User :   Had a second ablation for afib (touch up) it was successful so far, but only been about 20 days. BP and heart rate have been up and down. I noticed on my post op report that might left atrial pressure was a mean of 15. Is this good or bad and why is BP up and down. I wasnt on alot of BP meds before surgery and now I am or have increased them.
Doctor :   Hi
Doctor :   Let me read the query
Doctor :   Can you tell me the numbers of BP
User :   today??
Doctor :   Yes, you may tell for any day?
User :   They have been running around 152/98 to 115/72 up and down. When I take meds the bp goes down for a couple of hours and then go back up. Feel this in my eyes and slight headaches.
User :   What about that left artrial mean presssure of 15??
Doctor :   Yes it is slightly high
User :   Take Metoprolol 75 x2 and lisinapril 20mg x 2
Doctor :   The normal LAtrialpressure varies from 6 to 12mmhg
User :   HTN causing the high LAP
Doctor :   Pulmonary Hypertension can cause high LAP
Doctor :   Systemic Hypertension does not cause LAP unless there is back ward flow of blood, I mean organic problem
Doctor :   Do you have the ECHO report with you?
User :   O...I asked him about that and he said I didnt have pulmonary HTN
Doctor :   It is really important to understand the whole diagnosis and the management yet taken to give any thing specific about the pattern of illness
User :   I have echo report from NOV but I have post op report to from 2 weeks ago
Doctor :   Can you share that with me?
User :   which one??
Doctor :   Both of them
User :   On the post op report it states Intracardiac Echo was used to guide the transeptal puncture uneventually. Left artial pressure was a mean of 15. Left artrial angiogram demonstrated no abnormalities
Doctor :   Ok
Doctor :   Any comment about the valves
Doctor :   Or dysfunction ?
Doctor :   Systolic or diastolic dysfunction
User :   Not on the Post Op ablation report
Doctor :   Nov report
User :   On the ECHo in Nov of 2010 LV size is normal EF was 65-69%
User :   RV size normal, LA size normal, RA size AAAAAAA AO root mildy enlarged, AV No structral abd
User :   MV No structal MV noted
User :   PV No structal PV noted
Doctor :   Ok great
Doctor :   What is your age?
User :   35
Doctor :   What is the heart rate now?
Doctor :   Any comments made by the doctor?
User :   stand by
Doctor :   Is it fluctuating too?
User :   133/88 and HR is 87 when the medication wheres off it all goes up. Well BP does mainly in the 140-150 and dia is anywhere 85-108
User :   Heart rate after morning meds, by afternoon its around 95-102
User :   Goes down at night after I take meds til I wake up and BP usually is 142/85 and HR is 98-100
Doctor :   Ok
Doctor :   The BP is fluctuating largely in a day
Doctor :   We have to find a reason for it
Doctor :   Could be non worrisome too
Doctor :   but it warrants a complete monitoring
Doctor :   The medicines are alright, may be a correction in the timings or dosages should do the trick
User :   I do smoke and Im trying to stop. Im 6'1 and 250. Been walking 2 miles now for about 2 weeks and have drop some wieght. Thought BP would be better and it is at times but not like it should be with all that meds on board.
User :   Does this indicate early CHF? Or Pulmonary HTN
Doctor :   That is good to know that you are trying to quit
Doctor :   and you walk a good
Doctor :   It does not
Doctor :   Pul HTN has no reason after reading the ECHO
Doctor :   Yes I am here
Doctor :   To answer to your question
User :   Sorry..that was fast
Doctor :   Do you have swelling of feet or shortness of breath?
User :   No swelling, sometimes I feel SOB but its not constant.
Doctor :   Is your daily activity affected by your current BP fluctuation and SOB?
Doctor :   I mean the exercise, households etc
User :   when I walk and run Im not SOB at all...surprising as much out of shape I am. Seems more when I rest.
User :   SO that left atrial mean pressure, does that mean the atrial is enlarged or damaged. Im just trying to get healthy and understand some things
Doctor :   ECHO does not indicate an enlarged LA
Doctor :   so do not worry
Doctor :   In fact you are doing better as you do not have problem when you walk or run
User :   That could change though huh?? Whats my best bet here??
Doctor :   so you should feel great about yourself
Doctor :   Your next step would be to see if the dosage and timing of blood pressure medication has anything to do with the fluctuating BP, I mean can it be bettered with simple alterations
Doctor :   otherwise, keep continuing your exercise and continue your efforts to quit smoke
User :   Well, I work at 6pm at night and get off at 6am. I try to keep it around that time.
Doctor :   Thats better
User :   So dont worry about that mean pressure then??
Doctor :   No
User :   Have bad gentics on both sides of family and trying to controll it early. I already had to episodes of afib and second or touch up ablation.
User :   So trying to make changes in my lifestyle
Doctor :   That is always good
User :   Ok, then thank you for your time. Have some POTSD
Doctor :   Come out of stress as you are completely doing good
Doctor :   Stress is a very good reason for fluctuating BP
User :   Ok...Im trying really hard.
User :   Im a paramedic so sometimes knowledge is my worst stress
Doctor :   However keep a record of the BP recordings, the time of the day, the position and limb recorded etc
User :   Yeah, I have one of those going..
User :   Thank you
Doctor :   Pleasure here
Doctor :   Bye for now
User :   Bye
Doctor :   Hope your queries were answered
Doctor :   Hi
Doctor :   Are you back?
User :   yeah, some anxiety, but I had a question. Dang 15.00 for a question so help me out. My first ablation was in july of 2010. I had a LA mean of 12 then and now I have a mean of 15. Changes there??
Doctor :   Ok the LA pressure can fluctuate
Doctor :   after ablation
Doctor :   More importantly how is the LA pressure done?
Doctor :   Was it just ECHO
User :   Intra echo when they were inside the atrium
User :   does that make sense??
Doctor :   But these can happen, after ablation
Doctor :   more over just do not be bowled by LA pressure alone
Doctor :   The near accurate way of LA pressure is Pulmonary artery wedge pressure
User :   OK...So Blood pressure in the heart or systemic can be higher after ablation surgery??
Doctor :   so ECHO generated pressure can be easy way of taking but not the accurate
Doctor :   yes
User :   Ok, a wedge pressure woud be done by catherzation huh? not going that far but that would be the most accurate??
Doctor :   yes
Doctor :   Please do not worry for now
Doctor :   Carry on with yoru medication
Doctor :   and check up with your doctor
User :   Ok, just trying to understand things to help me make me better. Maybe im reading to much into it.
User :   ok thanks again..sorry to bother
User :   Do I get half back since this wasnt 30 minutes...LOL
User :   Hello
Doctor :   Oh
Doctor :   I am not aware of that
Doctor :   I am only a medical doctor
Doctor :   You can contact the customer care team
User :   ok
Doctor :   YYYY@YYYY
Question is related to
Medical Topics
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor