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What Would Cause High Blood Pressure And Sinus Tachycardia Postpartum?
Question: This is regarding my wife aged 34 years. We have two children one aged 3.5 yrs and other 3 months. She delivered a baby boy in Feb 2018. Her health usually remains fine and during second pregnancy everything was normal.
Post delivery after about 1 month when we visited our Gyn. Doctor for routine check up, her pressure was to be found 160/100. He prescribed Depicor SR 20 twice daily. Pressure was normal after 10-15 days. She skipped the medicine for some days. Again her pressure rised.
This time on visiting an Medicine specialist, he asked for ECG, USG Whole abdomen, cholesterol test, sugar tests, routine blood test and urine test. Two findings noted- sinus tachycardia in ECG and minimal BT plural effusion in USG. Chest x-ray was done and found ok.
She is presently taking Depicor SR 20, Eritel Ch 40. Her pressure is measured today at 144/100 after taking this medicines. She is given another medicine named Aticard 25 along with the above pressure medicines. Along with this some multivitamins is also given.
We are worried. Kindly advise for further course of action.
Post delivery after about 1 month when we visited our Gyn. Doctor for routine check up, her pressure was to be found 160/100. He prescribed Depicor SR 20 twice daily. Pressure was normal after 10-15 days. She skipped the medicine for some days. Again her pressure rised.
This time on visiting an Medicine specialist, he asked for ECG, USG Whole abdomen, cholesterol test, sugar tests, routine blood test and urine test. Two findings noted- sinus tachycardia in ECG and minimal BT plural effusion in USG. Chest x-ray was done and found ok.
She is presently taking Depicor SR 20, Eritel Ch 40. Her pressure is measured today at 144/100 after taking this medicines. She is given another medicine named Aticard 25 along with the above pressure medicines. Along with this some multivitamins is also given.
We are worried. Kindly advise for further course of action.
Brief Answer:
Nothing to worry about
Detailed Answer:
Hello,
There is nothing to worry about it. This is pregnancy-related hypertension and settles in most of the women within few months. However, some patients may have hypertension on long-term basis or risk of hypertension in the future.
So now our priority is to control BP. Is she breastfeeding or not. She may continue the medicines which are advised. However, in my opinion, especially if she is breastfeeding, then she should have Tab Amlodipine 5 mg once or two times a day depending on the need. Later she may be started on atenolol is needed. Small pleural effusion may be due to Depicor, if her hemoglobin is low, it will resolve with time.
I would like to avoid Eritel if she breastfeeding, and stop Depicor as it's a weak drug. I guess she doesn't have any chest pain, shortness of breath. We usually subject patients with pregnancy-associated hypertension to echo as well, so If it's available then try to have one. Check her hemoglobin as well as it can also sinus tachycardia along with anxiety.
So overall, she should stop Depicor, and also Eritel if breastfeeding (although not absolutely contraindicated), and have Tab Amlodipine 5 mg once a day and later increased to two times a day depending upon the need. Later if needed Atecard may be added.
So please discuss these things with your local doctor. And nothing to worry about it at this stage. Ask her to have low salt diet, regular exercises, and regular BP monitoring, and bp should be less than 140/90 mmHg.
Hope this helps you and get back if you have any doubts.
Nothing to worry about
Detailed Answer:
Hello,
There is nothing to worry about it. This is pregnancy-related hypertension and settles in most of the women within few months. However, some patients may have hypertension on long-term basis or risk of hypertension in the future.
So now our priority is to control BP. Is she breastfeeding or not. She may continue the medicines which are advised. However, in my opinion, especially if she is breastfeeding, then she should have Tab Amlodipine 5 mg once or two times a day depending on the need. Later she may be started on atenolol is needed. Small pleural effusion may be due to Depicor, if her hemoglobin is low, it will resolve with time.
I would like to avoid Eritel if she breastfeeding, and stop Depicor as it's a weak drug. I guess she doesn't have any chest pain, shortness of breath. We usually subject patients with pregnancy-associated hypertension to echo as well, so If it's available then try to have one. Check her hemoglobin as well as it can also sinus tachycardia along with anxiety.
So overall, she should stop Depicor, and also Eritel if breastfeeding (although not absolutely contraindicated), and have Tab Amlodipine 5 mg once a day and later increased to two times a day depending upon the need. Later if needed Atecard may be added.
So please discuss these things with your local doctor. And nothing to worry about it at this stage. Ask her to have low salt diet, regular exercises, and regular BP monitoring, and bp should be less than 140/90 mmHg.
Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you so much sir for your kind advise.
She is breastfeeding. Her hemoglobin was tested normal. We had asked our doctor regarding the breastfeeding matter and use of these medicines - Depicor/Eritel CH 40/Atecard 25. However he suggested to continue them presently and if the BP reduces below 90(diastolic) he will withdraw depicor first.
We are following low salt diet for her. Please advise what kind of exercises she can do to lower BP. We are also checking BP regularly.
She is breastfeeding. Her hemoglobin was tested normal. We had asked our doctor regarding the breastfeeding matter and use of these medicines - Depicor/Eritel CH 40/Atecard 25. However he suggested to continue them presently and if the BP reduces below 90(diastolic) he will withdraw depicor first.
We are following low salt diet for her. Please advise what kind of exercises she can do to lower BP. We are also checking BP regularly.
Brief Answer:
She can do walking, brisk walking
Detailed Answer:
Okay.. She may perform exercises like walking, brisk walking or even jogging at a slower pace according to her capacity. Otherwise, care should be taken to avoid excessive weight gain, so calorie restriction like avoiding too much fatty, oily and sweets will help. Also, discuss if can be kept off eritel till breastfeeding is completed, as data regarding its safety is not available. All the best.
She can do walking, brisk walking
Detailed Answer:
Okay.. She may perform exercises like walking, brisk walking or even jogging at a slower pace according to her capacity. Otherwise, care should be taken to avoid excessive weight gain, so calorie restriction like avoiding too much fatty, oily and sweets will help. Also, discuss if can be kept off eritel till breastfeeding is completed, as data regarding its safety is not available. All the best.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Sir sorry to get back as we ran through more doctor visits. In the last couple of days ECO, Renal artery Doppler and some blood tests were done. Test results were normal except some low level of potassium. Her BP is reduced to 120/70 now. She was taking Depicor SR 20, Eritel ch 40 and Atecard 25.
However now, the present medical consultant has changed the medicines and has advised to take - Depicor SR 20, Bisoheart 5 and Zolahart 80( advised to stop Eritel and Atecard). Also for low potassium Potklor syrup is suggested. She is breastfeeding our three month baby. She is physically fit.
Kindly advise.
However now, the present medical consultant has changed the medicines and has advised to take - Depicor SR 20, Bisoheart 5 and Zolahart 80( advised to stop Eritel and Atecard). Also for low potassium Potklor syrup is suggested. She is breastfeeding our three month baby. She is physically fit.
Kindly advise.
Brief Answer:
How much was her potassium, keep close watch
Detailed Answer:
Hello,
Firstly, how much was her potassium. Both low and high is not a good thing. So keep close watch over it. Get it repeated alternate daily till she is on potassium supplements.
Now, actually speaking, there is no difference in the medicines. The change ones are of same family, just minor differences amongst them. However, some minor superiority is considered for the new ones, but there are no practical differences. So starting new regime is also fine. If you wish to continue previous one then it's also fine, there is no issue about that. Most importantly, bp should be under control, these salts doesn't make much difference. However, just monitor bp as sometimes bp may go down excessively with new meds. Some monitoring symptoms, like weakness, dizziness, increased sleepiness suggestive of low bp.
How much was her potassium, keep close watch
Detailed Answer:
Hello,
Firstly, how much was her potassium. Both low and high is not a good thing. So keep close watch over it. Get it repeated alternate daily till she is on potassium supplements.
Now, actually speaking, there is no difference in the medicines. The change ones are of same family, just minor differences amongst them. However, some minor superiority is considered for the new ones, but there are no practical differences. So starting new regime is also fine. If you wish to continue previous one then it's also fine, there is no issue about that. Most importantly, bp should be under control, these salts doesn't make much difference. However, just monitor bp as sometimes bp may go down excessively with new meds. Some monitoring symptoms, like weakness, dizziness, increased sleepiness suggestive of low bp.
Above answer was peer-reviewed by :
Dr. Prasad
Potassium is found to be 2.94( ref range. 3.50 to 5.10 mmol/L as mentioned in the lab report).
Her BP is now 120/70 from the initial 160/100. We will check BP regularly now as advised by you.
So can she strart the new medicines - Depicor, Zolahart 80 and bisoheart 5 together with potassium supplement POTKLOR syrup? Hope there is no harm in these medicines.
Her BP is now 120/70 from the initial 160/100. We will check BP regularly now as advised by you.
So can she strart the new medicines - Depicor, Zolahart 80 and bisoheart 5 together with potassium supplement POTKLOR syrup? Hope there is no harm in these medicines.
Brief Answer:
Ok, please get potassium rechecked
Detailed Answer:
Get her potassium rechecked as there is no reason for low potassium in her like kidney disease etc so possibility of false report is always there.
She can start with new medicines, no harm should happen. My only concern is of low bp as zolahart is bit in higher dose of 80 mg. Anyway, just monitor bp, and potassium as she is on supplements. All the best.
Ok, please get potassium rechecked
Detailed Answer:
Get her potassium rechecked as there is no reason for low potassium in her like kidney disease etc so possibility of false report is always there.
She can start with new medicines, no harm should happen. My only concern is of low bp as zolahart is bit in higher dose of 80 mg. Anyway, just monitor bp, and potassium as she is on supplements. All the best.
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Above answer was peer-reviewed by :
Dr. Prasad
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