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Low BP, vomiting, weak. Meaning of narrow pulse pressure?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
Blood pressureSometimes my blood pressure is
low.70'sover30's. I vomiting and gets weak. Today I felt bad after working in the yard. Hours later my blood pressure was 101/91. Whay does a narrow pulse pressure mean?
Posted Sat, 28 Apr 2012 in General Health
Answered by Dr. Raja Sekhar Varma 13 hours later

Thank you for your query.

Before answering your question, I would like to know some more details from you to suggest you better.

1. What is your age and gender?
2. How long have you been suffering?
3. Does the Blood Pressure become low by itself, or only after vomiting or loose motion?
4. Do you have any other medical illness?
5. Are you taking any medicines?
6. Have you ever lost consciousness due to low Blood Pressure?
7. Have you done any blood tests, ECG (Electrocardiograph), or Echo (Echocardiography) of the heart?

Pulse pressure is the difference between the systolic BP (the top reading) and the diastolic BP (the lower reading). The usual range is between 30 - 50 mm of Hg. The systolic BP is the maximum pressure achieved when the heart pumps blood. The diastolic BP is when the heart relaxes after pumping and is also related to the resistance offered by the blood vessels. A narrow pulse pressure can result from a low systolic BP and/or a high diastolic BP.

A feeble pulse, on the other hand, is a felt by the doctor when he examines the pulse and finds that the strength of the pulse is low. Low BP is one of the causes of a feeble pulse.

Since there are many causes for a low BP, I would need more input from you to reach a diagnosis and offer some treatment options.

Hoping to receive the answers to my questions soon.

Above answer was peer-reviewed by
Follow-up: Low BP, vomiting, weak. Meaning of narrow pulse pressure? 29 hours later
i am a 50 year old white female. i had a stress test about 10 years ago.indicating pac's. echocatdigram showed mild backflow. i have had sleep apnea for approximately 8 years. the sleep Dr. asked if i had severe chronic pain because of abnormal alpha waves. the response was affirmative. i have 3 herniated and or ruptured discs in my neck and two herniated.disks in herniated discs in back. i also have lumber instability as shown by xray. i have several vessels in the brain in which the neurologist like rapids going through a narrow straw. my arms feel numb and tingly due to discs in neck. i am physically weak.approximately 5 months ago i went to Dr.who did blood work up. she said significant finding were my blood sugar was 101. my vitamin d was 14.7. i have been diagnosed by several psychologists as having Ptsd. i had grand male epilepsy from the age of 5 until i was 17 years. in the last couple of years.i have fainted approximately 6 times with no convulsions. i was married for 28 years to a retina surgeon. he left about 5 years ago for the usual reason. however. i had not expected it and when he left. he left completely. i never went to court because i had always believed in him. now. i am alone and because he sought to protect his reputation people have been told.outrageous reasons for his leaving me for a then married employee. i am basically submissive and when someone gets angry i get very frightened and blood pressure drops. i get pale and nauseated and usually vomit. i don't know how to control my weak sometimes absent low blood pressure or occasional fainting.i have no health insurance. my ex refused to assist.with that.
Answered by Dr. Raja Sekhar Varma 15 hours later
Thank you for the reply.

It appears probable that you are having syncopal episodes. The most likely reason for this is a vasovagal/situational syncope (neurocardiogenic syncope). The exaggerated vasovagal reflex results in a slowing of the heart rate and a fall in BP, leading to a reduction in blood flow to the brain and thus, a temporary loss of consciousness with fall. Once you are horizontal, the effect of gravity is nullified and the blood flow to the brain improves and you regain your consciousness.

There are some other causes of syncope also, like a tachyarrhythmia (rapid beating of the heart), intermittent heart block (with slowing of the heart rate), blockage (stenosis) of certain heart valves, obstruction to blood flow to the brain (carotid stenosis, vertebrobasilar insufficiency, etc) which can also result in loss of consciousness.

There are some simple preventive steps that you could take:
1) Keep yourself well hydrated. Drink adequate amounts of water.
2) Extra salt in the diet
3) Wear tight stockings, to prevent pooling of blood in the leg veins
4) Avoid sudden changes in posture; for example, getting up from the bed suddenly, bending down suddenly, etc
5) Avoid prolonged standing in one position. Move around, stamp your feet.
6) Avoid emotional situations that precipitate these events.
7) When you get the premonition that you may have a fainting episode, just lie down wherever you are. You may not always prevent loss of consciousness, at least, you can avoid injury due to the fall.
8) Tilt training: Stand upright with your back against the wall, feet together. Ensure that there are pillows around, in case you have a fall. Ensure also that there is something you can hold on to, if you feel giddy. Try standing like this for a few minutes (say, 3 - 5 minutes) initially. Once you gain confidence, you can increase the duration of standing gradually.

There are some medicines that might be helpful, if these measures fail. But, before prescribing medicines, it is necessary to prove the diagnosis with some investigations like head-up tilt table test, echocardiogram, carotid/vertebral doppler, and if indicated, a Holter monitor/Electrophysiologic testing.

I hope this answer will prove useful to you. I hope that you will find the strength of mind to move forward, forget the traumatic events of the past and lead a healthy life.

With regards,
Dr RS Varma
Above answer was peer-reviewed by
Follow-up: Low BP, vomiting, weak. Meaning of narrow pulse pressure? 34 hours later
thank you for your response Dr.Varma. i appreciate your knowledgeable and thoughtful response. without health insurance it is difficult to stay on top of my healthcare. although i feel there is definitely emotions related to my medical conditions. i have validated the overt physical responses to my emotions. except for being diagnosed with PTSD, i have never had any other psychological indicated to me. although i have remained mostly silent about my history, i have been repeatedly physically and emotionally abused over many it seems when a traumatic emotional event occurs, my body almost reacts as if it is in acute shock. i don't seem to be able to control the way my body acts on it's own like Pavlov's dogs. i wish i knew something to strengthen my heart and blood pressure so it would not go into a shock mode. if you have anything to add i would be most appreciative. my son began med school this year and i want him to have a mother who is in good health that can remain here til he completes his education. i don't want anything to cause a distraction for him by becoming seriously ill.etc. thank you again for your time and attention to me.
Answered by Dr. Raja Sekhar Varma 8 hours later
Thank you for your kind comments.

The most important thing for you now is to follow the simple steps that I have outlined for you and see how much improvement occurs over a period of 1 - 3 months.

All those measures will serve to prevent the hypotension and syncope. Remember that it is only an exaggerated reflex phenomenon that temporarily causes these symptoms. Your heart and blood pressure are not weak.

It is important to understand the reasons behind your fainting episodes and realize that it need not affect you psychologically. Your mental strength and will power will go a long way in providing you relief.

You need to learn from your experiences and build your defences in a logical and healthy manner, and not let yourself be browbeaten. You will have to consciously condition your body and mind to behave rationally and react on the basis of sound reasoning rather than raw emotion.

I am sure you will be able to come out of all these issues and lead a happy life.
With regards,
DR RS Varma
Above answer was peer-reviewed by
Follow-up: Low BP, vomiting, weak. Meaning of narrow pulse pressure? 7 hours later
Dr XXXXXXX Sekhar Varma:
thank you very much. it is like a reflex or acute shock. my ankles are swollen yet Dr. ruled out vein involvement. when frightened, i urinate completely which is embarrassing. i normally have no leakage between these acute stressful periods. i was once slightly confident that i made it through the years of beatings and death threats and functioned at a high level winning academic scholarships and awards in chemical engineering nursing and writing. then since my divorce i have been abandoned by own extended children are my only family that i have now. the rejection have left me disillusioned and i have noone to turn to when things are overwhelming. i don't know why i am having such a difficult time.thank you for your encouragement. God bless you.
Answered by Dr. Raja Sekhar Varma 1 hour later

Thank you for writing back.

Considering all your circumstances, I think you are holding out well. Everybody goes through troubled times. The rains make one appreciate the sunshine, darkness the light and so on. Keep up your morale and seek newer ventures, new friends and new interests. Keep yourself occupied and try not to dwell on the past. Your children need you and they will, in turn, be a source of strength for you.

I wish you all the very best for the future.
Dr RS Varma
Above answer was peer-reviewed by
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