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Having hypertension and bursitis of the shoulders. Tingling in hands, breathlessness and cough after physical exertion. Chances of heart problems?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
41 yrs bmi of 28 told have hypertension played rugby got pain in both shoulders could not lift with arms (bursitis injection) inflammed calfs tingling in hands could not walk far breathless for 4 months after, now cough when exerting say carrying babby upstairs, get occasional pains in centre of chest down left arm. doc gave me ecg said normal heart but high blood pressure. change diet and done exercise ( have lot of stress PTSD debt unemployment) bp gone from 170/130 now down to 147 /99 pulse 77, bp now 133/83 but pulse gone up to 96 or 122/86 and pulse 78 when at rest. should i get a test for angina, could i have had a heart attack playing rugby that would caused the shoulder pains . never though about heart probs till dr told me about high blood pressure
Posted Fri, 20 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 4 hours later

Thank you for your query.

I understand that you have hypertension, bursitis of the shoulders, mildly overweight and anxiety/stress disorder. I need some clarifications from you so that I can give you a specific answer.

1) Are you taking any medicines for any of the above? Or is the BP controlled only with diet and exercise?
2) Do you get any chest discomfort while exerting? Or is it only breathlessness?
3) Are there any other risk factors for heart disease like smoking, diabetes, abnormal cholesterol levels, family history of heart disease, etc?

A BP of 122/86 and a pulse of 78 per minute are within normal limits. The shoulder pains are probably unrelated to cardiac disease.

In view of the exertional symptoms, it is better to get a stress test done. This could be in the form of a treadmill exercise test, a nuclear stress imaging or a dobutamine stress echo. If the stress test is positive, you need to undergo a diagnostic coronary angiogram.

These tests are to detect any significant blockages that might already be present in the coronary arteries that supply blood to the muscles of the heart. They DO NOT usually predict a heart attack. A heart attack is a sudden occurrence of a blockage due to blood clotting inside the coronary artery. Prediction of an attack is difficult. A statistical probability alone can be told depending on your risk profile. It is usually easier to say who are less likely to get an attack rather than say who will get one.

Kindly get back to me with answers to the questions that I have asked so that I can give you a more specific answer.
Awaiting your response,
With regards,
Dr RS Varma
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