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ER Recorded BP 282/110, (without Meds Within Minutes) BP Dropped

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Posted on Thu, 18 Jun 2020
Question: ER recorded BP 282/110, (without meds within minutes) BP dropped to 118/72.
Other symptoms: profuse sweating, nausea, chest pain, anxiety, elevated heart rate.
These episodes have been occurring 6 to 10 times a day lasting 4 to 5 minutes.
ER Physician prescribed: Minnipress and Amlodipine
The symptoms still persist. What can I do?
doctor
Answered by Dr. Priyank Mody (23 minutes later)
Brief Answer:
Considering your age, I strongly recommend a thorough cardiac evaluation

Detailed Answer:
Hi,

Minipress can also cause a drop in BP... So, you might want to recheck that. Your symptoms need further cardiac evaluation...

Let me know if I can assist you further...

Regards



Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Priyank Mody (45 minutes later)
Had Cardiac Stress Test done and results were within normal ranges.
ER Physician stated that an adrenal dump (from the glands atop the kidneys) into the bloodstream may put your body in a fight-or-flight state that played a part in the drop of BP and the profuse sweating and chest pain.
This condition, for me and my husband, is distressing.
What else can I do?
doctor
Answered by Dr. Priyank Mody (14 hours later)
Brief Answer:
Yes adrenaline rush does explain the symptoms

Detailed Answer:
Hello ,
A rightly pointed out by your doctor the adrenaline rush can cause rise in blood pressure , chest discomfort nausea .
The only context is the rise is pressure to 280 is a dangerous thing and so must be evaluated to make sure about two things .
1) It didn't cause any problem during that episode to any vital organ including your heart , brain , kidney@
2) Such episode dreamt happen again .

Now other aspect I wanted to discuss was the fall from 280 to 120 . You said that it was without any medication which is again unusual.
So there is a possibility that there might be some miscommunication in your understanding .

Basic and Stress test rules out any significant underlying heart problem so we can close that part of evaluation at this point .

Now before we start medication. We need to establish
1) Whether you are Hypertensive
2).What are the reading at different times of the day.

The best test here would be
24 hour ambulatory BP monitoring.
if not available you can buy any machine and keep the recording at different times of the day .

Based on the reading we can start appropriate medication .

ARB ( angiotensin Receptor Blockers ) and a small dose of Beta blockers would be more ideal in your treatment.
The same can be discussed with your doctor .

Regards
Dr. Mody
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 918 Questions

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ER Recorded BP 282/110, (without Meds Within Minutes) BP Dropped

Brief Answer: Considering your age, I strongly recommend a thorough cardiac evaluation Detailed Answer: Hi, Minipress can also cause a drop in BP... So, you might want to recheck that. Your symptoms need further cardiac evaluation... Let me know if I can assist you further... Regards