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Suggest Treatment For Chest Pain And High BP
Question: My husband has been experiencing chest pain and BP was a little high, went to ER, they wanted to admit him but he refused. Followed up with a Cardiologist and had ultrasound, EKG and stress test and all came back normal. They felt it was due to lack of sleep and stress and advised to try melatonin and vallarian root to help sleep, (this is all since Monday evening) . In addition to the chest pain, he has a pounding headache and ringing in his ears. I am waiting for a call back from the Cardiologist but wanted to know if this is a sign of something more serious or if can be stress and anxiety?? He is 53 and 15-20 pounds overweight but in good health. Non smoker and takes no medication.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that his symptoms seem to be related to anxiety and the changes of his regimen (sleep deprivation).
Have you measured his blood pressure?
Changes in blood pressure (uncontrolled high blood pressure and even low blood pressure) could also cause pounding headache and ear ringing.
I would advise you to closely monitor his blood pressure several times during the day (in sitting position after 15 minutes of total relax) and refer these values to his attending physician.
Regarding his chest pain, a cardiac cause has been excluded, based on his performed cardiac tests.
Other causes of chest pain should be excluded like: possible musculo skeletal pain, a gastro esophageal reflux or esophageal spasms, a lung disorder, etc.
Further tests should be done for this purpose :
- chest x ray study
- PCR, sedimentation rate (inflammation)
- kidney and liver function tests
- thyroid hormone levels (a thyroid dysfunction could lead to high blood pressure, sleep disorders and anxiety)
A fibrogastroscopy may be needed to exclude possible gastro esophageal disorder, if suspicions are raised for such a disorder.
Meanwhile, I would recommend discussing with your attending physician on the possibility of switching to another therapy instead of melatonin and vallerian, like possibly benzodiazepines (which are more effective as sedatives for short term therapy) or an antidepressant like trazodone, amytriptiline, etc, which would help him with anxiety and his sleep disorder.
Hope to have been helpful!
Please, feel free to ask any other questions, whenever you need!
Best regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that his symptoms seem to be related to anxiety and the changes of his regimen (sleep deprivation).
Have you measured his blood pressure?
Changes in blood pressure (uncontrolled high blood pressure and even low blood pressure) could also cause pounding headache and ear ringing.
I would advise you to closely monitor his blood pressure several times during the day (in sitting position after 15 minutes of total relax) and refer these values to his attending physician.
Regarding his chest pain, a cardiac cause has been excluded, based on his performed cardiac tests.
Other causes of chest pain should be excluded like: possible musculo skeletal pain, a gastro esophageal reflux or esophageal spasms, a lung disorder, etc.
Further tests should be done for this purpose :
- chest x ray study
- PCR, sedimentation rate (inflammation)
- kidney and liver function tests
- thyroid hormone levels (a thyroid dysfunction could lead to high blood pressure, sleep disorders and anxiety)
A fibrogastroscopy may be needed to exclude possible gastro esophageal disorder, if suspicions are raised for such a disorder.
Meanwhile, I would recommend discussing with your attending physician on the possibility of switching to another therapy instead of melatonin and vallerian, like possibly benzodiazepines (which are more effective as sedatives for short term therapy) or an antidepressant like trazodone, amytriptiline, etc, which would help him with anxiety and his sleep disorder.
Hope to have been helpful!
Please, feel free to ask any other questions, whenever you need!
Best regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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