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Why is my blood pressure low when taken in right arm while laying on my left side? Chest pain, dizziness.

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
When I lay on my left side and take blood pressure in right arm the readings are from 82/42 to 95/55. Why is this so low?

Laying on back it's typically 110/65 and during day is 115/70 to 130/85. I have had a nuclear stress test, many ekg's and 3 different cardiologists tell me I'm ok but I just recently started performing at home blood pressure.

30 Yr old male. Sometimes chest pains and dizziness. Pains into arm/back. Was diagnosed with costochondritis. 5'11 175lbs
Posted Sat, 28 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 4 hours later
Thank you for your query.

Lying on the left side and measuring blood pressure on the right arm is a WRONG TECHNIQUE.
The BP cuff and the heart should be on the same level. Otherwise, you will get all these erroneous readings which confuse you and make you think that something is abnormal.
I would suggest the following:
•     Please use the standard techniques for measurement of blood pressure (BP). If you are measuring BP at home with an electronic gadget, please get the instrument standardized against the usual mercury apparatus.
•     Take rest for at least 15 minutes before BP measurement, unless you want to see the BP response to exercise.
•     Avoid smoking, tea, coffee, or any other drinks for half an hour before measuring your BP.
•     Measure BP while seated comfortably with the arm supported on the table, and the BP cuff at the same vertical level as the heart.
•     Use a cuff size that is appropriate to your arm circumference. Avoid repeated measurements too close to each other.
The measurements of BP that you have provided in lying down position and other readings through the day are all normal. There will be minor variations in the BP depending on the time of the day, your mental and physical condition, stress, exercise, food, hydration level, salt intake, etc. These are generally accepted as normal.

I hope this answers your query. Feel free to contact me for any specific clarifications.
With regards,
Dr RS Varma
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