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Severe chest pains, fluctuating BP, sweating during night. Blood test normal. EKG abnormal. How to treat it?

I came home from the hospital yesterday after 2 days there due to severe chest pains waking me up during the night and highly fluctuating blood pressure . All blood tests were normal but blood pressure was high and then low and then high again. This also happened in Feb and one abnormal EKG reading happened and the other EKG readings were OK. I had one abnormal EKG reading this time also (the first one) I was sent home and told to see my cardiac specialist (although another doctor from his group saw me in the hospital and he could not explain what was happening) After the blood pressure was OK for about 6 hours, they discharged me. I woke up sweating during the night and the pain is slowly coming back. This morning my BP was 169/85. I was given BP meds yesterday at 10:30am and was told to take another one at bedtime last night, which I did. What should I do?
Asked On : Thu, 24 May 2012
Answers:  1 Views:  154
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Cardiologist 's  Response
Hi Improve10,
I am a cardiologist and I thank you for writing in.
Undoubtedly you have hypertension whether isolated systolic (169/80 mm Hg) or flutuating or persistent. I am concerned here about answer to three questions, namely:
A. Whether your hypertension is primary or secondary to some other disease? You hve been hospitalised seen by specialit apparently all othr causes seem to have been excluded exept Pheochromocytoma, discus with your doctor if he has any suspicion he would order suitable investigatons. Secondly
B. Has the hypertension has caused any target organ damage on Heart, Brain or Kidney. You have not mentioned about kidney and brain these seem safe so far. You mentioned chest pain and one possible abnormal EKG. Your doctor will agree with me that you need cardiac workup an echocardiography with Doppler examination and after proper control of BP a treadmill test or stress Thallium; depending upon results you have to undergo coronary angiography.
C. Hypertension and stress which are evident from our history ar risk factors at times silent for coronary artery disease and presence of these always prompts us to look for other namely: Family history, abnormal lipid profile, diabetes, obesity & sedantary life style and some personality profile. Idea is to diagnose and treat these at the earliest before harm is done.
Best Wishes

Dr Anil Grover
Answered: Thu, 24 May 2012
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