HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

History Of WPW-ablated, Psvt, Atrial Tachycardia And Sinus Tachycardia. Post Syndrome And A Pacemaker Implanted. Curefor Hypertension?

Posted on Tue, 28 May 2013

Question: Hello I am a 23 year old female with a history of WPW-ablated, psvt, atrial tachycardia and sinus tachycardia. I also have pots syndrome and a pacemaker implanted for possible yacht XXXXXXX syndrome. I am of normal weight and height, and other than asthma have no other health problems. My problem is all antihypertensive drugs are causing extreme supine hypertension, which is unbearable. My doctors are stumped, and I need to control my fast heart rate. What could be causing the exteme supine hypertension?

Answered by Dr. Jorge Brenes-Salazar (11 hours later)

Dear patient,

Thank you for your health concerns. I wanted to clarify your question: do you have a history of hypertension? If so, which medications are you taking? Are these medications resulting in HYPOtension (low blood pressure) when supine?

Thanks for clarifying the details.

Dr Brenes Salazar

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Jorge Brenes-Salazar (3 hours later)

No I don't really have a history of hypertension.i had high blood pressure after the birth of my son but it was preeclampsia related. No my blood pressure is going high when laying down. It is normal when standing. I've tried numerous beta blockers, verapamil, and lately cartia

Answered by Dr. Jorge Brenes-Salazar (6 hours later)

Thanks for providing additional information.

Yours is a very atypical situation; I suspect some autonomic dysfunction might be related to your symptoms. Your cardiologist may order an autonomic screening including an ambulatory blood pressure monitor to understand the blood pressure changes further.

In terms of antihypertensive classes, the ones associated with less blood pressure variability are calcium channel blockers like amlodipine and diuretics. Discuss with your treating doctor about these classes of antihypertensives.

Hope this information might bring some initial insight on your complex case. Let me know if you need clarifications.

Wish you the best health

Dr. Brenes Salazar, MD

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Jorge Brenes-Salazar (3 hours later)

Thank you for your answer. What types of autonomic dysfunction should I maybe be looking for, besides the Pots syndrome that I already have. I will ask about amlodipine or a diuretics. It would be nice to get my heart rate under control.

Answered by Dr. Jorge Brenes-Salazar (9 hours later)

thanks for the follow up. some examples of abnormal or paradoxical responses can be seen in dysautonomic syndrome and autonomic dysreflexia, both associated mainly with nervous system conditions

in terms of heart rate control, there are other medications available such as digoxin, ivrabadine (in Europe) and some of the class 3 antiarrhytmics

hope this helps with your queries wish you the best health in your journey

dr brenes salazar md

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

Follow up: Dr. Jorge Brenes-Salazar (2 hours later)

I'm sorry but one last question. I am not a worrier usually but I do know wht autonomic dysreflexia is. There is no way I could have that correct?

Answered by Dr. Jorge Brenes-Salazar (22 hours later)

Thanks for your follow up.

I agree it would not be typical as we see it more frequently in cases of spinal cord injury.

Hope this is helpful.

Wish you the best health.

Dr Brenes Salazar
Mayo Clinic

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

Above answer was peer-reviewed by : Dr. Mohammed Kappan