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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Two Episodes Of Low BP. Have A- Fib, Diabetes, AVR Replacement. On Warfarin. Concerned?

Have been asked by my nephrologist to measure BP 4X daily. I started this early this week and have experienced two episodes (late afternoon) when systole and diastole are close and BP very low (85/62 for one example). I have a-fib and diabetes , AVR replacement and some mitral insufficiency. Am on Warfarin for prosthetic aortic valve, antihypertensives, and Coreg for a-fib. BP has been in normal to low range for last six months and has been getting lower. I am 76 and still working. What should my MD be looking for? I am concerned.
Wed, 12 Jun 2013
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Cardiologist,  's  Response
Dear patient,

The main issue that needs to be ensured is that the aortic valve replacement and pressures are working appropiately; if the valve is not working right then you can see a drop in blood pressure and "narrowing" of the difference between systolic and diastolic BP. A good echocardiogram can sort this out; sometimes though, a transesophageal echocardiogram is needed to look well at the aortic valve.


Yours truly,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
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Had Two Episodes Of Low BP. Have A- Fib, Diabetes, AVR Replacement. On Warfarin. Concerned?

Dear patient, The main issue that needs to be ensured is that the aortic valve replacement and pressures are working appropiately; if the valve is not working right then you can see a drop in blood pressure and narrowing of the difference between systolic and diastolic BP. A good echocardiogram can sort this out; sometimes though, a transesophageal echocardiogram is needed to look well at the aortic valve. Yours truly, Dr Brenes-Salazar MD Cardiology Mayo Clinic MN