What Causes Severe Chest Pain While Treating Hypertension?
Question: My friend in Wales was given norvasc six weeks ago for high blood pressure. He is 68 years old and weighs around 150 pounds, height 5'7. Until January he felt great, is very active, works at his barber shop, travels often, and can walk circles around me and ends up having to pull me behind him because I get tired walking up and down hills and such (I'm 56). He went to see doctor in January because of chest pain, but not necessarily heart pain. He says that if he turns his head far left or far right, his hands tingle and feel numb. He says his chest aches in front and around his back. Sometimes he doesn't have the pain. It comes and goes. He also has a "spur" type growth on his spinal chord near the top of the back of his neck that he's known about for several years. He was a professional drummer and has played drums regularly since age 12, and he thought this might have something to do with how he plays drums and nods his head while playing for 50 years. He has not been given any dx yet, he is still waiting to see a cardiologist. Since taking norvasc, he feels exhausted and dizzy. He is too tired to work or do much of anything. Today he called me very upset because both his feet, ankles, knees, and thighs are swollen. He said it happened in a matter of minutes. He was feeling well today and had sat outside in the sun for about an hour, then came inside. That's when his legs became swollen. He said they were fine while he was outside in the sun. He said both lower extremities are very tight and uncomfortable. He's frustrated and as his friend, so am I. Any advice? Please? I'm afraid those British doctors are going to kill him before even finding out what's causing his pain that he went in about initially. Thank you, XXXXXXX XXXXXXX XXXX
Brief Answer:
Explained
Detailed Answer:
Hello and welcome
I appreciate your concern
Based on your description, a cardiac cause for the chest pain needs to be ruled out. A baseline EKG followed by a stress test / exercise tolerance test (ETT) should be done. If there are no ischemic changes then a cardiac cause is unlikely. If significant changes are found then angiography can be advised and necessary intervention can be done as well such as Stenting or CABG. The amlodipine (norvasc ) is associated with pedal edema and can lead to swollen lower limbs with fluid accumulation.
Let me know if you have any query
Wishing you best of health
Thanks
Explained
Detailed Answer:
Hello and welcome
I appreciate your concern
Based on your description, a cardiac cause for the chest pain needs to be ruled out. A baseline EKG followed by a stress test / exercise tolerance test (ETT) should be done. If there are no ischemic changes then a cardiac cause is unlikely. If significant changes are found then angiography can be advised and necessary intervention can be done as well such as Stenting or CABG. The amlodipine (norvasc ) is associated with pedal edema and can lead to swollen lower limbs with fluid accumulation.
Let me know if you have any query
Wishing you best of health
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks you for your response. My concern tho, is that he hasn't seen the cardiologist yet and hasn't had any tests run on his heart such as the ones you mentioned. Yet he was started on norvasc before having a cardiac diagnosis. He feels worse now since seeing a doctor than he felt before he saw one. Both he and I are all for finding out if he has a heart condition. We're just wondering if starting this particular medication for his blood pressure might be premature. There are so many types of medications for hypertension out there, perhaps norvasc wasn't the appropriate choice to begin with since he has no diagnosis of angina or other heart condition. At least not yet. Since he is accustomed to an active lifestyle, feeling exhausted and dizzy all the time has been very frustrating for him. Now with both his legs swelling up, it's like the last straw. He's about ready to quit seeing doctors altogether since he's been several times since January and still has no diagnosis about a heart condition and still doesn't know why his chest still hurts. His chest pain has not been affected at all by taking norvasc. Thank you for any further insight. XXXXXXX XXXXXXX
Also, is there anything he can do about his swollen legs? Should he drink more fluid? Or less? Will they go down on their own?
Also, is there anything he can do about his swollen legs? Should he drink more fluid? Or less? Will they go down on their own?
Brief Answer:
Explained
Detailed Answer:
Hello again.
Amlodipine can be advised as part of management of hypertension, Coronary artery disease and angina. It could have been advised for elevated blood pressure or the suspected angina to see for improvement.
Fluid intake should not be increased. The prospect of stopping amlodipine should be considered in consult with your doctor.
Let me know if you have any query
Wishing you best of health
Thanks
Explained
Detailed Answer:
Hello again.
Amlodipine can be advised as part of management of hypertension, Coronary artery disease and angina. It could have been advised for elevated blood pressure or the suspected angina to see for improvement.
Fluid intake should not be increased. The prospect of stopping amlodipine should be considered in consult with your doctor.
Let me know if you have any query
Wishing you best of health
Thanks
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar