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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes chronically low blood pressure?

Answered by
Dr.
Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Posted on Mon, 6 Apr 2015 in Hypertension and Heart Disease
Question: i do not have syncope but my bp drops very low lot of times and it makes me very bad feeling on top of anxiety
doctor
Answered by Dr. Lilit Baghdasaryan 40 minutes later
Brief Answer:
Need more information

Detailed Answer:
Dear Sir,

For answering to your query I need more information.
Could you describe more detailed when your blood pressure drops,
what are provocative factors,
how low does it drop
how long does it last
what is your normal blood pressure
what is your bisoprolol dosage
Are your PVCs controlled
Are the blood pressure drops connected with anxiety or panic attacks

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan 4 minutes later
Dear sir,

my pvc are not controlled.

my bp goes below 90/60 sometimes. mainly pulse pressure becomes 20 or lower thats when i have even worse feelings.

normal bp is 100/70

my bisoprolol is 2.5 mg twice a day.

its the other way lot of times when i have panic attack my bp is low and even pulse pressure is low.
Please could you refer my attached echocardio report and advise if the report is normal..how often is echocardiogram to be done.
doctor
Answered by Dr. Lilit Baghdasaryan 4 hours later
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

For the patients whose normal blood pressure is 100/70 mm Hg, blood pressure of 90/60 mm Hg is not low. Blood pressure is not a constant data, it changes during the day, it get higher after exercise, after some time from eating, it drops a little during sleeping, while lying etc. Blood pressure variations up to 15 mm Hg is considered normal. If your blood pressure drops don't exceed 15 mm Hg, so it is normal and your complaints are nor related to blood pressure data. In this case likely they are related to anxiety. If your blood pressure drops more than 15 mm Hg, then I would advise you to undergo 24 hour ambulatory blood pressure monitoring to find out the cause. It can be related to your medication as well. But you should also know that you should measure blood pressure three times and take the average, which will be the real pressure.

For PVCs I would advise to perform holter monitoring to see the exact amount of PVCs during a day, if they are less than 800/day, then there is nothing to worry, everything is ok. In case they are more than 1000/day, your doctor should revise your treatment. In this case I would recommend some additional tests such as thyroid test and serum potassium.
I had a look on your angiogram and echo, they are normal and nothing to worry.

Also I would advise you to avoid measuring your blood pressure during panic attacks.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan 9 hours later
Thankyou for your reassurance.

I would like to point out an irritant for me which is why I chose to put my query on here inspite of visiting cardiologist so many times...

when i am working or even sleeping,the veins are pulsating visibly under my nose,eye and arms. this happens with pain in left and right side of chest,arms and palpitations/skipped /irregular flip flops....

As you mentioned the PVC reports for me are not very important...then but the pvcs happen to me continuously even when i occupy my mind and try to ignore the pvcs.this basically takes away normal life....

please guide if i must ask my cardio for some other test/treatment?
doctor
Answered by Dr. Lilit Baghdasaryan 1 hour later
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

If you are very symptomatic with PVSs and feel every other PVC , then you should discuss your treatment with your doctor.
Sometimes when PVCs can't be controlled with medication, we go for ablation. But we go for it after trying all possible medications and ruling out all other possible causes.
If you were my patient I would perform a holter monitoring, 24 hour ambulatory blood pressure monitoring, blood tests for thyroid function and electrolytes. The treatment strategy would depend on the results.
Wishing you good health

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