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Diagnosed with a moderately enlarged heart and uncontrollable high blood pressure. Proper diagnosis?

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Practicing since : 1981
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Ihave year's ago been diagnosed with a moderately enlarged heart, uncontrollable high blood pressure that varies greatly from 190-125 to 115-70. But usually its high. When I was still playing tennis 4 years ago, at times I couldn't go on after 20 minutes. Normal was 3-4 hrs. Last few years, under very high stress from custody battle I have been mostly resting in bed. Now I also have tendonitis in my ankles, so walking isn't going well. I went for the fun of it on an elliptical machine but 1 minute wore me out. I don't work, because I wouldn't make it there, even dokter appointments I miss if I can't get out of bed. I failed the stress test few years ago, after 2 minutes of thread mill, just walking, the machine was abruptly stopped, cardiologist came running in claiming I needed to take meds for the rest of my life. I have also hypo-pituitarism and take lot of hormones. I am predisposed for emphysema due to zz-alpa one anti-trypsine deficiency and have sleep apnea.
Posted Tue, 20 Nov 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 1 hour later
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
For the purpose of analysis of your problem it can be divided in two issues related to cardiology.
1. High fluctuating Blood Pressure, Large Heart, Had been advised rest probably congestive heart failure.
a. You must have been prescribed medicines for high blood pressure. Please take these regularly. One thing more as blood pressure is fluctuating. Ask your doctor for ambulatory blood pressure where blood pressure is recorded for 24 hours and pattern is analysed. It helps a lot in adjusting the timing of dosage of your medicines. In your follow up query please mention about drugs you are taking.
b. You must have been prescribed medicines for congestive heart failure. Please let me know if echocardiography has been done in you and what does the report say. So that further suggestions can be given.

2. Hypo-pituitrism, zz-alpha one anti trypsine deficiency and tendonitis of ankle joint. Inability to actively move

Solution: For your medical problems you would have been given therapy and special diet. Please religiously follow that. You had been active only few years ago, now bed ridden, I can understand your problem. Incidentally, how much do you weigh and what is your height? I read about conclusion of stress test. Can you write to me EKG report in your next mail? May be I can suggest some exercises which are mild in nature and legs and feet are not used. That depends upon your heart condition. Please do schedule an appointment with a cardiologist, you can use services for people with limited walking ability and go on wheel chair. In San XXXXXXX CA you can call 2-1-1 or 858-300-1212 in advance of your appointment day for such services.
My worry is whether you -when you claim- you "failed stress test" ; whether it was because of coronary artery disease or it was too risky to perform because of associated conditions for there are alternatives. You are too young to give up to bed ridden life! Looking forward to hear from you. Good Luck.
With best wishes.
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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