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Suggest Treatment For Twinges Of Pain And Pressure With High BP
I have been having twinges of pain all afternoon with some level of pressure and discomfort. I have already had two heart attacks but I m not dry heaving and I haven t collapsed like before. I also have extremely HBP and I have had a stroke about two years ago. My last heart attack was 4 months ago. My doctor said I am an enigma because I don t look at all sick and I m not overweight, my HBP has been contributed to stress, all my blood work came back good every time. Should I go to the ER? Thank you.
Fri, 5 Sep 2014
.Hi,
Thank you for your query. I can understand your concerns.
You are a patient of hypertension and coronary artery disease. You had a stroke two years ago,mainly because of your hypertension which is a single major risk factor for stroke.
Your new onset pain and discomfort since afternoon could be related to uncontrolled /accelerated hypertension (ischemia as a result of an increase in oxygen demand due to LV hypertrophy secondary to hypertension)+/- unstable angina (secondary to coronary atherosclerosis ),as you mentioned your status of extremely high BP (must be on some occasion). You need to visit ER or any consultant to get your BP checked along with a fresh ECG ( to rule out any possibility of unstable angina/fresh attack). In case your ECG is inconclusive you may have to undergo enzyme studies like Troponin-T level to remain on safer side,as it is sometimes difficult to interpret fresh heart attack on ECG with old myocardial infarction.Meanwhile you may take PPI (proton pump inhibitor) like pantoprazole or omeprazole 20-40 mg single dose orally. It may give some relief if the pain/discomfort is related to GERD(gastro-esophageal reflux disease),which is not uncommon with cardiac patent taking antiplatelet drug like aspirin.
Regards
Dr. T.K. Biswas M.D.
Mumbai
Thank you for your query. I can understand your concerns.
You are a patient of hypertension and coronary artery disease. You had a stroke two years ago,mainly because of your hypertension which is a single major risk factor for stroke.
Your new onset pain and discomfort since afternoon could be related to uncontrolled /accelerated hypertension (ischemia as a result of an increase in oxygen demand due to LV hypertrophy secondary to hypertension)+/- unstable angina (secondary to coronary atherosclerosis ),as you mentioned your status of extremely high BP (must be on some occasion). You need to visit ER or any consultant to get your BP checked along with a fresh ECG ( to rule out any possibility of unstable angina/fresh attack). In case your ECG is inconclusive you may have to undergo enzyme studies like Troponin-T level to remain on safer side,as it is sometimes difficult to interpret fresh heart attack on ECG with old myocardial infarction.Meanwhile you may take PPI (proton pump inhibitor) like pantoprazole or omeprazole 20-40 mg single dose orally. It may give some relief if the pain/discomfort is related to GERD(gastro-esophageal reflux disease),which is not uncommon with cardiac patent taking antiplatelet drug like aspirin.
Regards
Dr. T.K. Biswas M.D.
Mumbai
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