Can a BP of 170/95 when under stress be considered as high?

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Posted on Wed, 10 Jun 2015 in Hypertension and Heart Disease
Question: Hi doctor I have a quick question. I have seen a cardiologist a few months ago who did all cardiac tests on me which came back normal except for some pacs and very few pvc which he says are due to anxiety and are not originating from my heart. I have my blood pressure checked often and it is usually around 135/80. When I do have very stressful days with anxiety and lots of stress my blood pressure goes up quite a bit. Sometimes 170/95 during panic. My cardiologist and family doctor both say that I do not have high blood pressure and that is a normal symptom of anxiety. Also he said if I did have high BP my heart muscles would be very thick in my ultrasound but everything was normal. Are these episodes dangerous especially with me having the etopic beats? Both my doctors say I'm fine
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
There is nothing to worry about, just a normal reaction

Detailed Answer:
Hello!

Thank you for your question on HCM!

Regarding your concern I agree with your doctor. It is normal to have a higher blood pressure and ectopic heart beats during a stressful situation. It is caused in healthy persons by the release of stress hormones like adrenaline from our body, to help us deal with the stressful situation.
These episodes are really short, and they are not dangerous for your body. They happen even in children.
The cardiac muscle thickening may develep when the basal blood pressure remains in high for a long time, but these are just some episodes which are not so long.
So I would recommend you to take a deep breath and be calm! There is nothing to worry about.

Your cardiac tests are normal, and this is really reassuring!
I would recommend you to take some betablockers in case of episodes of anxiety, like propranolol. It will help you deal with these symptoms during these episodes .

Hope to have been helpful!

Feel free to ask any other question whenever you need!

Greetings! Dr. Iliri






Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ilir Sharka 11 hours later
Hi doctor

My cardiologist insists that I do not need medication because my symptoms or etopic beats are not frequent. Also my regular blood pressure check ups are usually in normal range. Also my resting heart rate sometimes goes to 55 so I think beta blocker would reduce it even further. I'm sorry doctor for all the questions it has been a difficult year for me. I lost my job last year while my wife was pregnant with our third child. I have three small children under 4 years old so I have been under a lot of stress which has caused the etopic beats. I was very worried that the etopic beats could affect my heart and my life. I'm glad to have met you on this site
doctor
Answered by Dr. Ilir Sharka 7 hours later
Brief Answer:
Just relax and try to relief you anxiety!

Detailed Answer:
Hello again!

I am sorry to hear about the difficult period you are passing through.

At the same time, I am glad to reassure you that nothing dangerous for your heart is voi g to happen by those rare and unimportant ectopic beats.

So, don't worry about that issue!

Meanwhile, I wouldn't recommend the use of beta-blockers, facing your rare ectopic beats and tour age.

I am here to offer you further support. So relax and try to relief your anxiety.

Best wishes! Dr. Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ilir Sharka 13 hours later
Hi doctor thank you once again for your reply. I looked up Roemheld syndrome and went to a forum where many people suspect they have the same thing. They all had cardiac tests come back normal but have cardiac symptoms. One individual said his heart has stopped a few times. Is it possible or did he have another condition? Can the stomach cause the heart to stop?
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
Yes! Roemheld syndrome can cause severe cardiac arrhythmia

Detailed Answer:
Hello again !
Yes it is possible in this condition to have cardiac arrhythmia induced by gastric abnormalities.
Roemheld syndrome is characterized by abdominal disorders triggering reflexes in the heart, causing cardiac arrhythmia, even a stopping of the heart rhythm. There are a number of pathways through which cardiac reflexes can occur: hormones, mechanical, neurological by vagal nerve stimulation and immunological.
Some of the symptoms of the disease are : Sinus bradycardia
angina or chest pain, fatigue,anxiety, uncomfortable breathing,muscle pain,vertigo or dizziness,sleep disturbances, extrasystoles.
All these symptoms are induced by gastro-intestinal disorders, while the cardio-cascular system is normal.

I don't think that this is your case.

But you can consult with your GP and have an abdominal ultrasound to be sure that everything is ok with your gastro-intestinal system.

Hope to have been of help!

Feel free to ask any other questions !

Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Ilir Sharka 17 minutes later
Hi doctor I had an abdominal ultrasound 4 weeks ago and everything was normal. .the symptoms I get though are sinus bradycardia sometime and tachycardia sometimes. Also some acid reflux. I'm very worried about the disorder that you explained is it ruled out with my ultrasound?
doctor
Answered by Dr. Ilir Sharka 17 minutes later
Brief Answer:
You should consult with the gastrohepatologist to be sure that you are OK

Detailed Answer:
Hello again !

The diagnosis of Roemheld syndrome is often made based on symptoms in the absence of heart abnormalities.

A gastroenterologist should perform a colonoscopy and fibrogastroscopy besided the ultrasound to locate or eliminate problems in the abdomen. The fibrogastroscopy would be more appropriate to your case because of the gastric reflux.

Determining the cause of Roemheld syndrome is still very difficult. But the cardiac arrhythmias occur at the same time with the abdominal problems and they repeat each time in the same pattern.

So if there are no abdominal problems, I think that we can exclude this syndrome.
I still think that you should not worry about this. It is not your case! Sinus bradycardia and tachycardia can occur in normal persons, from physical or psychological stress.

Just be calm, and do not think about it any more!

Feel free to ask any other questions!

Greetings! Dr. Iiri

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Ilir Sharka 3 hours later
Doctor thank you for explaining this all to me. Just a few more questions about it and then I will close the discussion. Is this a common syndrome? I know in Canada and the United States doctors don't believe in this but it makes sense to me. Also with all the cardiac tests I had , if I had this syndrome wouldn't a dangerous arythmia show up? Also my fast heart rate such as 170 bpm does not happen every day only on certain occasions for example I went 2 months without it happening. With Roemheld syndrome do the symptoms occur everyday? How common is it for the heart to stop because of this? Is it normal for an otherwise healthy 32 year old to have this?
doctor
Answered by Dr. Ilir Sharka 18 hours later
Brief Answer:
This is a very rare disorder and can cause life-threatening arrhythmia

Detailed Answer:
Hello again!

I understand your concern.

This is a rare disorder, but the fact that it is misdiagnosed makes it even more rare. In fact there are not many publications on this disorder, because it is really rare.
I don't think that you have this syndrome. All your tests are within the normal limits for a healthy person.
I agree with you in the fact that if you had this disorder you would have had severe arrhythmia or some of the other symptoms I mentioned before, in correlation with abdominal pain and distension or other abdominal complaints. They don't occur every day, but very often and are always caused by a gastrointestinal disorder.
So I would advise you just not to worry! Every thing seems to be OK with you.

In such a long time an abdominal disorder would be detected during your routine checkups.

Hope to have been helpful to you and answered most of your questions.

Feel free to ask any questions you need to! I am at your disposal any time.

Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ilir Sharka 21 minutes later
Hi doctor thank you for getting back to me. What worried me is the bradycardia I experience often. I know it's only slight bradycardia around 55 bpm. I imagine the disorder would cause much worse bradycardia? Also I have noticed sometimes my heart rate while standing is 58-60 bpm. Not always only sometimes. Is that normal?
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
You don't have to worry about your bradycardia!

Detailed Answer:
Hi XXXX!

I understand you have passed through a difficult time, and it is normal to be worried about your health.
I would like to explain that your mild sinus bradycardia is completely normal. And you don't have to worry about that.
I don't brlieve you have that syndrome. Nevertheless, in such case, the heart rate may obviously vary a lot.

Best regards! Dr. Iliri
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7223 Questions

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