
Had Myocardial Infarction. EKG Is Normal. Having Reoccurring Spikes. Took Isosorbride Mononitrate. Should I Increase The Medication?

I am so sorry to hear about the MI and the various BP spike and accompanying symptoms. I understand how distressing this is and more so because it keeps you away from what really make you happy. I do honestly wish we get to figure out a cause and provide a long lasting solution to this.
Episodic High blood pressure and elevated pulse should raise the suspicion of a pheochromocytoma(tumour of the adrenaline which intermittently releases huge amounts of adrenaline and noradrenaline which are excitatory hormones). This presents with a classic triad of profuse sweating, raised blood pressure and headaches lasting a few minutes and then disappears within minutes. It is often confused with panic attacks and anxiety disorders. I will suggest that you get investigated for this by doing a hormonal test. If the results are in support of this, then your physician will continue by referring to and endocrinologist who will do more detailed tests that may include a CT scan, MRI etc.
I hope this addresses your query and provides guidance on the way forward. If there are more questions related to this or more specific issues you had wished i address, please ask specific follow up questions.
I hope together we make at least advances towards identifying this cause and providing long lasting solutions.
Dr. Ditah, MD.

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