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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Fluctuations In Blood Pressure?

My husband is a cancer survivor (squamous cell carcinoma of the neck). He went through two rounds of radiation and chemo (2006 and 2007). He has arteriosclerosis and COPD. His blood pressure will be rather high at night but by 10 am it will bottom out. He takes midodrine to bring it up. His doctors don t seem to have any answers but I m afraid the daily dropping will eventually cause kidney damage or worse. Any suggestions (even as to what type doctor he should see - the primary care physician or cardiologist don t have any answers and don t seem to take it seriously).
Tue, 2 Sep 2014
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Psychiatrist 's  Response
Hi welcome to HCM.
Your husband has significant changes in blood pressure.The high blood pressure in his case can be clearly explained on the basis of underlying atherosclerosis and COPD.The nocturnal falls of blood pressure warranting the use of midodrine should prompt for the onset of Orthostatic hypotension due to underlying autonomic dysfunction which can develop in individuals treated with longterm chemo and radiotherapy.Tilt table testing and 2dimensional ECHO can help in formulating the diagnosis.I advise you to visit a cardiologist for further expert management.
Thank you
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What Causes Severe Fluctuations In Blood Pressure?

Hi welcome to HCM. Your husband has significant changes in blood pressure.The high blood pressure in his case can be clearly explained on the basis of underlying atherosclerosis and COPD.The nocturnal falls of blood pressure warranting the use of midodrine should prompt for the onset of Orthostatic hypotension due to underlying autonomic dysfunction which can develop in individuals treated with longterm chemo and radiotherapy.Tilt table testing and 2dimensional ECHO can help in formulating the diagnosis.I advise you to visit a cardiologist for further expert management. Thank you