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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Medication For High Bp

I am a 51 years old female and I have been diagnosed with SVT in 2004. I ended up in A@E as I collapsed. Rapid heart beat 180 and incrased BP. Put on medication, fine till 2007, yet another collapse, changed medication, varieous test been done ECG on SO ON. I was ok till 2009 and since then the episodes have increased and the time span from 6 month to 3 month, now it happenes on a 4 weekly basis. I am on Sotalol 80 mg twice and Amlodipine 5mg at night one. Since January this year I have more symptons. I now have high blood pressure, blue hands and lips, loos of balance, co-ordination increased dizzy spells and mild pressure behind breast bone. My last episode was last week. This came out of the blue. I was driving the car and suddenly I felt a bit weired,my heart started to raice fast, felt dizzy, faint, my hands changed colour from blue to white cold hands, lips blue, pale skin, waves of pressure behind my breast bone. Which lasted for one hr. BP 195/104 P 104. After about 2 hr. BP down to 160/85 P 85. I am still not right, I have small episodes of that every day. My feet are getting numb too now at times and it comes on at anytime, not physical related. No stress, nothing. My BP is at times high than low from 160 - 110 and my P goes down to 52. My arteries are fine and my valves are working fine. I end up in A@E and they send me home when I am medical stable. My GP looking into my kidney function and I had many blood test done. Every time I have an episode either consious or lose consiouness, I take longer and longer to recover and I am so tiered after that. I need to sleep for hrs. I am not in controll of this as it can happen anytime. Can you help of what I need to do. Thank you
Tue, 24 Jan 2017
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Internal Medicine Specialist 's  Response
Hi,
SVT, uncontrolled hypertension, dizzy spells, cyanosis of lips , hands and vertigo (coordination) all indicates symptoms of chronic heart failure and Ischemic hypertensive encephalopathy. First of all, it is very important to distinguish whether the arrhythmia (SVT) is permanent atrial fibrillation (I guess it is as u are on Sotalol), holter monitoring should be done to find out frequency of paroxysmal episodes and proper cardiologist consultation( with lipid profile, recent ECG, holter and echocardiogram) should be seeked in case of severe interruption of day to day activity so that a ablation could be arranged if required. Hypertension can be controlled by taking combos such as Losartan+Hydrochlothizide intially 100/12.5 in the morning. Amiodarone can be used during paroxysmal episodes of atrial fibrillation 200mg (accoring to treating physician's advice) Also supportive therapy should be considered to avoid neuro circulatory complication during hypertensive crisis such as IV Pyracetam infusion after complete evaluation.

Dr.Uppal

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Suggest Medication For High Bp

Hi, SVT, uncontrolled hypertension, dizzy spells, cyanosis of lips , hands and vertigo (coordination) all indicates symptoms of chronic heart failure and Ischemic hypertensive encephalopathy. First of all, it is very important to distinguish whether the arrhythmia (SVT) is permanent atrial fibrillation (I guess it is as u are on Sotalol), holter monitoring should be done to find out frequency of paroxysmal episodes and proper cardiologist consultation( with lipid profile, recent ECG, holter and echocardiogram) should be seeked in case of severe interruption of day to day activity so that a ablation could be arranged if required. Hypertension can be controlled by taking combos such as Losartan+Hydrochlothizide intially 100/12.5 in the morning. Amiodarone can be used during paroxysmal episodes of atrial fibrillation 200mg (accoring to treating physician s advice) Also supportive therapy should be considered to avoid neuro circulatory complication during hypertensive crisis such as IV Pyracetam infusion after complete evaluation. Dr.Uppal