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What Causes Decrease In BP Level?

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Posted on Fri, 5 Dec 2014
Question: my mother is asthama patient.she had acute chest pain yesterday morning.we rushed to hospital and reached around 12:45. PFT and ECG performed. Pulmonary specialist referred to cardiologist. Cardiologist advised to have angioplasty. She admitted around 5pm. Angioplasty done. At 3am after almost 8hours of aangioplasty doctor told us BP is getting low inspite of medicine. She is in ICU. What is the risk and cause. She is 50 years old.
doctor
Answered by Dr. Harshal Vora (1 hour later)
Brief Answer:
Low blood pressure is a bad sign post heart attack

Detailed Answer:
Hello welcome to HCM.
I have read your question and understand your concerns.

Your mother probably has heart attack, it's a condition in which one of the 3 major vessels supplying heart muscle got blocked and can permanently damage area supplied by that vessel. So, kindly mention about the diagnosis so that we can have more clearer idea. (angioplasty is a procedure by which we put stents in a blocked artery so that it can again be reopened)

Usually after an heart attack, heart pumping becomes weak. Usually people can sustain blood pressure at low pumping also and pumping can be improved somewhat in 6 weeks. But in some patients pumping becomes so weak that they can't sustain even normal blood pressure also. In this type of patients unless they recover we have to give medicines to improve blood pressure.
If she doesn't maintaining blood pressure even with medicines then it's a poor sign unfortunately.
We called it Cardiogenic shock.

Cardiogenic shock has high mortality(death) chances. So kindly watchful about her urine output, her consciousness levels, her electrolyte levels and oxygenation levels also.

Doctor will try their best to keep blood pressure normal, don't worry.

Inraaortic balloon counterpulsations (IABP) is a machine we usually used in patients whom blood pressure is not mainataing with medications also. So kindly ask your doctor about it in priority basis, as it can improve blood pressure.

I hope I have given you satisfactory answer, any further questions are always welcome.
Thank you.
Have a nice day.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Harshal Vora (45 minutes later)
thank you very much for your advice sir. i have attachéd initial comments of doctor before angioplasty. doctors are watching her. what should be done further? any further surgery?
doctor
Answered by Dr. Harshal Vora (1 hour later)
Brief Answer:
No surgery to be done. IABP is the option available

Detailed Answer:
Hello. Welcome again.

I have been gone through your reports. It is a massive heart attack. Anterior wall is a main wall of heart and LAD artery is major vessel. Her echo report has mentioned pumping capacity. I think it would be around 25-30%.

Doctors have already done what they can do. Angioplasty is the definitive procedure in heart attack. Now she has to come out on her own. No surgery is required or even existed for this type of problem.

IABP what we have discussed earlier can increase chances of survival if her by increasing her blood pressure. So kindly consult your cardiologist regarding this.

It's a tough situation for you as she is of young age. But take decisions calmly.

Any further questions are appreciable.
Thank you.
Best of luck.
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Harshal Vora (30 hours later)
Sir, thank you very much for your kind guidance. I read nursing staff's progress chart they are monitoring urine output. Urine output was not proportionate with liquid intake they said. Is there any chance to any effect on kidney? They performed CPR tonight around 3am. I was worried. I talked to cardiologist about IABP, he told that he initially thought about that but at present not required. Dietician was saying sugar level is high at present don't know the reason but my mother had not been detected sugar earlier. Doctor told to give water to drink and pomegranate to eat on trial basis. I thought it must be good sign but it seems dietician differs to the idea to provide pomegranate. Small amount of pomegranate given. I am happy that they thought about IABP and urine output as suggested by you. Please suggest any further course of action. Thank you. I mouth published your suggestion among my MBBS friends
doctor
Answered by Dr. Harshal Vora (2 hours later)
Brief Answer:
Conditions is still critical at present.

Detailed Answer:
Hello welcome again. Thank you very much for your praise towards me..

You have told me about CPR(cardiopulmonary resuscitation). Are you sure? Because CPR means her heart has been stopped for a while and reverted. It's like coming back from death. So, if that's true then she is lucky but condition is very critical..

If urine output and serum Creat is adequate then her kidneys are functioning adequately.
How is her blood pressure at present?

In such a critical situation blood sugar may rise, it might be temporarily elevated. But you can go for HBA1c report. It's a confirmatory report for diabetes.

If she is conscious to take food then its really good sign. If her blood pressure is remaining around 100/60 mmhg even then also it's kidney will function normally and she can recover.

Two most important things are blood pressure and heart rhythm.

Your doctor's are doing adequate job, so Trust him and do whatever they say.

Any further questions or confusions are always welcome. Don't hesitate to ask.
Best of luck.
Have a nice day.
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Harshal Vora

Internal Medicine Specialist

Practicing since :2009

Answered : 321 Questions

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What Causes Decrease In BP Level?

Brief Answer: Low blood pressure is a bad sign post heart attack Detailed Answer: Hello welcome to HCM. I have read your question and understand your concerns. Your mother probably has heart attack, it's a condition in which one of the 3 major vessels supplying heart muscle got blocked and can permanently damage area supplied by that vessel. So, kindly mention about the diagnosis so that we can have more clearer idea. (angioplasty is a procedure by which we put stents in a blocked artery so that it can again be reopened) Usually after an heart attack, heart pumping becomes weak. Usually people can sustain blood pressure at low pumping also and pumping can be improved somewhat in 6 weeks. But in some patients pumping becomes so weak that they can't sustain even normal blood pressure also. In this type of patients unless they recover we have to give medicines to improve blood pressure. If she doesn't maintaining blood pressure even with medicines then it's a poor sign unfortunately. We called it Cardiogenic shock. Cardiogenic shock has high mortality(death) chances. So kindly watchful about her urine output, her consciousness levels, her electrolyte levels and oxygenation levels also. Doctor will try their best to keep blood pressure normal, don't worry. Inraaortic balloon counterpulsations (IABP) is a machine we usually used in patients whom blood pressure is not mainataing with medications also. So kindly ask your doctor about it in priority basis, as it can improve blood pressure. I hope I have given you satisfactory answer, any further questions are always welcome. Thank you. Have a nice day.