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Have High BP. Why Am I Feeling Itchy On The Rib Cage?

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Posted on Tue, 27 Nov 2012
Question: Left rib cage has been ithcy kind of feeling on the inside (under the skin), off and on for the last two weeks. What would cause this? I notice it is triggered when I am sitting. I don't feel it when I am sitting. I also noticed my blood pressure gets about 140 over 90 and pulse about 60 when this is happening. I am fit and my pulse is normally 50 to 65, and blood pressure 120 over 75ish.
doctor
Answered by Dr. Anantharamakrishnan (41 minutes later)
Hi friend
Welcome to Health Care Magic

There is typing mistake too – you don’t feel when you are lying?

The description is not detailed enough to direct to a diagnosis. Probably you have allergy / irritation of a nerve root...

Blood pressure of 140/90 is in the high normal range – temporary rise like this may be from anxiety.
Your heart rate is on the lower side.

Though there are no clues to suggest something serious, it is wiser to get investigated.
The best option will be to see a cardiologist.
A thorough history and physical examination is the first step -
Routine 12-lead Electrocardiogram (ECG) is part of clinical examination.
24 to 48 hour ambulatory monitoring (Holter) may be necessary for the rate.
Treadmill exercise ECG (TMT) may be necessary for the discomfort.
ECHOcardiogram may be done to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes, and so on.
The treating doctor will suggest based on the situation.


Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (12 minutes later)
I had an ECG and it was perfect. I have a history of anixety. Everything is stemming from the weird sensation I feel in my left rib area. I am fine laying down and such, but when I sit for at least ten minutes, I start getting that feeling in the left ribs, and then I notice my blood pressure. Could damage to the phrenic nerve cause this? I had blood work two weeks ago and everything was fine. I also had my finger pricked to check for diabetes and I believe it was 5.4. I just need to know what is causing this feeling in my ribs, and if that is the cause of bloor pressure.

Thank You
doctor
Answered by Dr. Anantharamakrishnan (4 hours later)
Dear XXXXXXX
It is good news and is heartening to see that Lab work and ECG are normal. Blood sugar of 5.4 is excellent indeed. Did you have an X-ray of Chest also?
Anxiety of course is appropriate - but why only on sitting up is the confounding factor? Anxiety accentuates this / this accentuates anxiety and a vicious cycle sets in... Positive attitude and changing the focus away from it will break the cycle. Anxiety can raise the pressure – but usually it is far higher and shorter in duration.
A normal resting ECG is reassuring indeed. Nevertheless, 24-hour recording to document and diagnose the fluctuating rate and pressure is a better proposition.
Damage to Phrenic nerve is unlikely to cause this. At the lower margin of every rib, run bundle of nerve (intercostal) and blood vessel. There could be a local inflammation at some point causing irritation...
It is really not possible to pin point the problem. Since it is already two weeks, it is unlikely to be serious / most of such events generally subside in another week or two at the most.

Regards
All the best

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (50 minutes later)
I took half of a 500 mg Robaxon and the pain has subsided some. I have not checked my blood pressure yet, in fear of getting anxiety while I do it. Does this sound like something to do with a nerve? How do you heal something like this?
And can nerve irritation cause blood pressure to rise?
doctor
Answered by Dr. Anantharamakrishnan (1 hour later)
Hi
It is good that Robaxon relieved the pain. It is muscle relaxant / Retrospectively, this could mean skeletal muscle spasm was contributing to the pain.
Focal nerve irritation does not raise the pressure directly - pain and anxiety from it can.
Don't be afraid to measure the pressure. Go ahead and check. Happy, if it is normal / if high, you can plan for further work up and treatment.

We can NOT give Beta blockers, because the heart rate is otherwise slow. (They are the ones generally given in most cases and help in pressure, fast rate and anxiety.) Muscle relaxants (you are already taking) / Over the Counter Anti-inflammatory analgesics like Ibuprofen / Anxiolytics like Specific Serotonin Re-uptake Inhibitors or Benzodiazepines - individually or in combination can help

Regards
All the best

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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Have High BP. Why Am I Feeling Itchy On The Rib Cage?

Hi friend
Welcome to Health Care Magic

There is typing mistake too – you don’t feel when you are lying?

The description is not detailed enough to direct to a diagnosis. Probably you have allergy / irritation of a nerve root...

Blood pressure of 140/90 is in the high normal range – temporary rise like this may be from anxiety.
Your heart rate is on the lower side.

Though there are no clues to suggest something serious, it is wiser to get investigated.
The best option will be to see a cardiologist.
A thorough history and physical examination is the first step -
Routine 12-lead Electrocardiogram (ECG) is part of clinical examination.
24 to 48 hour ambulatory monitoring (Holter) may be necessary for the rate.
Treadmill exercise ECG (TMT) may be necessary for the discomfort.
ECHOcardiogram may be done to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes, and so on.
The treating doctor will suggest based on the situation.


Take care
Wishing speedy recovery
God bless
Good luck