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Taking Warfarin For Asthma. Having Variable Blood Pressure. Echocardiogram Done. Should I Be Concerned?

Posted on Mon, 27 Aug 2012

Question: Until I was about 30, I had a normal, healthy BP. At that age, pulse pressure started to widen. Now, at age 60 it is usually 70 +/- 2, with systolic usually 120-130. I an 70" tall, weigh 159 lbs, have asthma and take warfarin because I have had two bad episodes of VTE. I have read that high pulse pressure can mean aortic stiffness. I have also read that high pulse pressure can mean aortic regurgition. 10 years ago, I had an echocardiogram to look for PFO, which was read as WNL. 18 mos. ago, I had an EKG which was also read as WNL. Do I even need to be concerned about this? Am I worrying needlessly?

Answered by Dr. Rakesh Madhyastha (8 hours later)

Hello

Thanks for the query

I would like to know a few more details in order to help you out

1. Do get chest pain either at rest or on exertion?
2. Any episodes of dizziness?
3. Do you have episodes of palpitation either after work or drinking caffeine?
4. If any blood tests were done recently could you attach the reports ?

Please get back to me, I am awaiting your reply

Regards

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

Follow up: Dr. Rakesh Madhyastha (1 hour later)

Dr. Madhyastha;

Thanks very much for responding to my query. Answers to your questions are below:

1. I do not get chest pain after exertion. I do get chest pain at rest quite often. I wouldn't describe it as an angina type of pain. It feels more like chest wall pain. Occasionally, if my asthma symptoms are worse than usual, it can be more like a pleuritic pain.

2. I do get occasional episodes of dizziness.

3. I do have occasional episodes of palpitation, usually upon exertion.

4. I have attached some blood tests from late last year. I am sorry I don't have any that are more recent.

Answered by Dr. Rakesh Madhyastha (29 minutes later)

Hello

Thanks for the query

I am happy that you are taking good care of yourself. Your pulse pressure is widened by about 10mmhg but this doesnt worry me as there are various reasons for them and also because it is not alarmingly high. Widened pulse pressure is seen in aortic regurgitation which you do not have as proven by your EKG and echo, pulse pressure also widens with stiffening of the arteries which is bound to happen as age progresses.

I would like you to repeat your complete blood count and lipid profile again now since been sometime. Lymphocytes were on the higher side and also your total cholesterol. Please approach a physician for the same.

Palpitation on exertion is normal it is because of increased heart rate to compensate for the extra work being done by the body but if it persists then it is an issue which requires further work up

I hope I have answered your query, if you have any further ones please get back to me

Regards

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

Follow up: Dr. Rakesh Madhyastha (29 minutes later)

I have read that a pulse pressure any greater than 50 is unhealthful. Not so?

Thanks for your thoughtful answer.

Answered by Dr. Rakesh Madhyastha (11 hours later)

Hello

Wide pulse pressure is seen in various conditions like right after exercise, aortic regurgitation, athletes, hardening of arteries, etc. individually it is of no clinical significance but definitely has to be worked up for ,which has been done in your case. There is nothing to worry about as of now.

Regards

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

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