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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Remedy For An Episode Of Chest Pain With Unexpected Hypertension?

56 yr old healthy female ( no cardiac risk factors- normotensive, excellent cholesterol) had episode of chest pain with unexpected hypertension- 180/140 initially, EKG normal, serial troponins all neg, stress EKG normal but huge discrepancies between upper extremity BPs at the end of stress test: rt arm 50 mmHg higher then lt arm (180/90: 130/90)- this resolved to 130/70 after 5 mins with 10 mmHg difference. What next- worried about vascular anomaly.......................
Thu, 30 Jan 2014
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Cardiologist, Interventional,  's  Response
from the history and investigations it is clear that she has hypertension, there is likely to be stenosis of left upper limb artery ( like subclavian a., axillary a.,brachial a.). so she needs to undergo CT angio for further evaluation. since renal artery stenosis also sometimes coexists , more so in presence of hypertension, so the ct angio should include the renal arteries as well. for the time being hypertension needs to be treated.
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What Is The Remedy For An Episode Of Chest Pain With Unexpected Hypertension?

from the history and investigations it is clear that she has hypertension, there is likely to be stenosis of left upper limb artery ( like subclavian a., axillary a.,brachial a.). so she needs to undergo CT angio for further evaluation. since renal artery stenosis also sometimes coexists , more so in presence of hypertension, so the ct angio should include the renal arteries as well. for the time being hypertension needs to be treated.