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Dr. Andrew Rynne

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Is blood pressure of 85/55 a cause for concern?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2850 Questions

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Posted on Sat, 25 Mar 2017 in Hypertension and Heart Disease
Question: Hello! A friend of mine is a 20 year old student. She has recently started to experience headaches, fainting, and fluttering of her heart. Her HR is 82, RR is 21, temperature is 98.5 degrees Fahrenheit and her BP is 85/55. She takes birth control and Ibuprofen for the headaches. She had the same symptoms between the ages of 10-13, and they came back in high school but went away for no specific reason. They become worse with stress, and the headaches get worse with stress. Thank you for the help!
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Answered by Dr. Bonnie Berger-Durnbaugh 13 minutes later
Brief Answer:
Information

Detailed Answer:
Hello,

Without being able to examine her, I can't say for sure what is going on, but here are some considerations:

1. Her blood pressure is on the low end, and sometimes in thinner young women, with low blood pressure, there isn't enough rise in pressure when standing up or being upright which can cause light headedness in those situations.

2. Stress can cause all of the symptoms mentioned. However, stress can also make underlying problems worse, so it is important to not just chalk it all up to stress until first making sure there isn't something underlying that is going on.

3. Regarding the heart fluttering, that may be from stress (palpitations from higher levels of stress hormones), but given all of these symptoms, she should go in to be evaluated for any heart trouble. An EKG should be done, and if it doesn't pick up the "flutter" episodes, and if her fluttering is associated with the light headedness or fainting, then a 24 hr (or longer) hotter monitor should be given. This is sort of like a continuous EKG recording that a person wears and then is interpreted by a cardiologist. Some basic labs should also be checked, such as a complete blood count, and also check TSH (for thyroid function)

I hope this information gives you and your friend some information to start with. Please let me know if I can provide further information.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 24 minutes later
Hello! She did have an EKG done, and it was normal except for one abnormal rhythm. She is slightly anemic, and her ventricle walls are slightly thinner. She also had chest pain after an echo. She is 5'7" and weighs 134 pounds. She is pale, and drinks coffee. She exercises regularly, and has no family history. My guess based on the internet is that maybe she has an arrhythmia. Any insight? Thanks!

The abnormal rhythm occurred after 2 minutes, and they also did a tilt table test. A hypotensive episode was induced at 60-70 degrees.
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Answered by Dr. Bonnie Berger-Durnbaugh 9 minutes later
Brief Answer:
Information.

Detailed Answer:
It would be important to know what the abnormal rhythm was that was seen on EKG. Some arrhythmias (abnormal rhythms) are innocuous where as others are more concerning.

An effort should be made to correct the anemia. There are different causes for anemia. If she looses a lot of blood with menstruation, then that should be addressed and also iron supplementation may help the anemia.

Depending on the abnormal rhythm that was identified, coffee in moderation may be ok.

I am not sure what the chest pain after the echo was about. If she had XXXXXXX infusion, that might be a reason, or if they pressed particularly hard on her chest wall during the procedure, that might explain it.

It would be a good idea to check thyroid function too.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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