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Diagnosed With Panic And White Coat Syndrome. Is High Blood Pressure Related To Anxiety?

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Posted on Mon, 3 Dec 2012
Question: Yesterday I had an unpleasent situation at dentist yesterday, I had an oral surgery and all was fine, but when i saw all that blood in my mouth i started freaking out, I have been diagnosed with panic and white coat syndrome.
Because there was so much blood the dentist asked the nurse to take my blood pressure, I told her not to do so as it would make matters worst and my blood pressure would go even higher...more blood was coming out as my blood pressure sure was going up, one point I took it myself and it was 235/110...I told the doctor it was very high.
They gave me valium then another one later till I came down a bit, blood pressure was oscilating between 180/90 170/87. The bleeding improved they were able to stitch me up and send me home.
I called my doctor this am that is aware of my anxiety and has monitored my blood pressure before and told me that I do not have a hight blood pressure, out of a doctors office it is always withing range, less then 120/80.
The doctor told me I should not worry about it as far as this is not a constant thing and that was due to my anxiety, he also suggested me to take a valium before a do a dental proceedure as he said most of my hight blood pressure is due to my anxiety with doctors. Can you please tell me your opinion? What should I do?
doctor
Answered by Dr. Anil Grover (1 hour later)
Hi XXXXXXX,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
What you have is form of anxiety, what's called a Blood Phobia, and you can faint when you see blood. That's not an uncommon condition, but it's very different from Panic Disorder but still a form of anxiety. Your doctor has rightly diagnosed as yet another manifestation of anxiety disorder for which you are being treated with Zoloft.
I entirely, subscribe to the view that this was one off situation and rightly mantaged though blood pressure of 235/100+ looks omnious. Next time if you are likely to encounter such situation, you can inform the staff, it will be taken care of. You will not see a drop of blood. Of course, white coat hypertension you will have to overcome by yourself with help of your doctor. One way is positive feedback behaviour, frequent hospitals visiting the cafetaria of the hospital for a cup of coffee and develop a few doctor friends.

The fact benzodiazepine group of drugs (anxiolytics like valium) were effective, In my opinion no further treatment for blood pressure is required apart from your 6 monthly screening check up for high blood pressure.
If there is further query which you might have I will be most happy to answer. Good Luck.
RegardsWith Best Wishes:
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anil Grover (17 minutes later)
My question is during any other given time my blood pressure is normal, I have maintained a journal and reviewed with my doctor and he said it is entirely normal.
My fear is not only of the blood, but of any medical environment and just going to a doctors office and taking my blood pressure will go up. So what can I do to control my blood pressure in a doctors office and having such high blood pressure like 230/100 for a short time while at the dentist could it be dangerous?
doctor
Answered by Dr. Anil Grover (3 hours later)
Thanks for writing back. I appreciate.
You are absolutely correct in both of your assertions:
1. Exposure to blood &
2. White Coat Hypertension that includes medical environment
have the potential to raise your blood pressure. But if you take anxiolytic medicine with your learned Doctor's advice(with which I absolutely concur) and repeated exposures to second situation will try to limit the blood pressure rise to safe limits. With your doctor's concurrence you can get yourself prescribed Clonazepam MD (mouth dissolving) tablet for situational anxiety as described in No 2. When I wrote one off phenomenon I was referring to No 1 that is blood phobia. And fortunately, neither the quantum nor the duration of rise in BP in second situation is life threatening. It will further reduce if you follow the abovesaid advice. Live life stressfree as much as possible that means good balanced diet, good aerobic exercise like brisk walking for 40 minutes a day and ban the junk thoughts entering your mind. Try Yogic exercises. You will do well. If you have further follow up question, I will be only too pleased to answer. Good Luck.

With Best Wishes.

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

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

Cardiologist

Practicing since :1981

Answered : 922 Questions

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Diagnosed With Panic And White Coat Syndrome. Is High Blood Pressure Related To Anxiety?

Hi XXXXXXX,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
What you have is form of anxiety, what's called a Blood Phobia, and you can faint when you see blood. That's not an uncommon condition, but it's very different from Panic Disorder but still a form of anxiety. Your doctor has rightly diagnosed as yet another manifestation of anxiety disorder for which you are being treated with Zoloft.
I entirely, subscribe to the view that this was one off situation and rightly mantaged though blood pressure of 235/100+ looks omnious. Next time if you are likely to encounter such situation, you can inform the staff, it will be taken care of. You will not see a drop of blood. Of course, white coat hypertension you will have to overcome by yourself with help of your doctor. One way is positive feedback behaviour, frequent hospitals visiting the cafetaria of the hospital for a cup of coffee and develop a few doctor friends.

The fact benzodiazepine group of drugs (anxiolytics like valium) were effective, In my opinion no further treatment for blood pressure is required apart from your 6 monthly screening check up for high blood pressure.
If there is further query which you might have I will be most happy to answer. Good Luck.
RegardsWith Best Wishes:
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW