75 y/o female having undiagnosed heart and blood pressure problems - PLEASE HELP!?
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I am seeking help for my 75 year old mother who is having heart and blood pressure related "spells" for the past 3 weeks but which have gone undiagnosed by the doctors. Here are the details: • Has been on high blood pressure medications for many, many years without incident (Avalide, Ziac and Norvasc) • Approx 3 weeks ago she started having “spells” where her heart would pound in her head, her face and ears become red and hot, feels nauseous and gets a headache, has ringing in her ears, stomach and chest feel hot, and the hot feeling radiates into both arms but is worse on the left, blood pressure goes WAY up (has been as high as 214/114) • These episodes have woken her up out of a dead sleep usually around 4 or 5am • Has had to call 911 two or three times, and has been transported to the hospital, but they haven’t been able to find any evidence of a heart attack or abnormality • Family doctor put her on a 24 hour holter monitor which showed 9 abnormalities (don’t know what those were), so he sent her to a cardiologist • Cardiologist changed her medications to: Metoprolol Tartrate (25 mg twice a day), and Lisinopril 10 mg once a day, which she’s been on for 2 weeks now • Cardiologist also gave her a holter monitor to wear for a week, but she never had a major spell during that time • D/C’d holter monitor Thursday, and ended up having her worst spell ever this morning. Called 911 and paramedics took her to the hospital. Gave her an aspirin at home, plus 2 nitroglycerine pills, and another in the ambulance on the way to the hospital. The paramedic said she was having some atrial fibrillation on the EKG but this didn’t show at the hospital. The nitroglycerine did help a lot – brought her BP down and helped the other symptoms, but while she was at the hospital, her cardiologist came to see her and said the results of her week-long holter monitor showed no clogged arteries (I didn’t know you could see this on a holter monitor), but since she didn’t have one of these really bad episodes while wearing the monitor, the doctor said he thought she might need to wear one for a month. He also doubled the amount of the two blood pressure meds he has her taking. Since they couldn't find any other problem, however, they sent her home. • In spite of the fact that her meds have been changed and she’s being monitored by a cardiologist, her episodes are getting worse • One other piece of information – she had a stress test in February 2010 that was normal At this point her cardiologist seems to be stumped but something is obviously wrong and I am very, very worried. If someone (preferably a doctor) has any ideas about what may be going on with her, PLEASE let me know. If you aren’t a doctor but have either experienced something like this yourself or with someone you know and think you can help, please share your information too. Thank you so much for your time! Sincerely, Tammy
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Answer:
There are very few doctors who have time to answer questions on Yahoo Answers. It sounds like your mother is having intermittent atrial fibrillation and her cardiologist is using the Metoprolol to try to prevent this from occurring (this is a heart rate control medication which also lowers blood pressure). They have also probably tested her thyroid function since it can give similar symptoms. Since she had no episodes while wearing the monitor, she needs to follow his recommendation for wearing it for a longer period so that they can catch episodes of whatever rhythm might be occurring. If this is atrial fibrillation, medications may be used to stop this from occurring. She probably also needs another stress test since these episodes are occuring after her last stress test - the test itself may bring on the rhythm disturbance so they could actually she the rhythm occurring. It can take multiple medication changes or dosage adjustments to get rhythm disturbances and elevated blood pressure under control which can require many doctor visits. Both of the dosages you have listed are beginning doses and may need to be increased to control the symptoms. You can go to WebMd.com and type in atrial fibrillation and read up on this condition. You can also type in low sodium, cardiac diet which lists foods that your mother should be avoiding. Salt is one of the offenders for high blood pressure. She needs to keep working with her doctors until she gets to the right medication and dosage that will control her symptoms.
tgsntx at Yahoo! Answers Visit the source
Other answers
it can happen in sleep apnoea syndrome and severe anxiety attacks. a thyroid or pheochromocytoma may produced this but symptoms differ,and doctor would have diagnosed it earlier. so talk to your doctor about this.
aziz
Man im just a kid but all i can say is i hope she gets better and i will pray for her good luck and i hope your mother gets well soon i wouldn't know what to do without my mom. - Trevor
Trevor B
stop drinking, or eating anything with caffine in it. herb tea's are the worst. keep a record of all foods, and if this happens. I had the vary same problems, it was a new herb tea I was given from a friend, on the 3rd day of drinking it, I thought I was going crazy and going to die.
madame x
what you describe sounds like a phenomenon called "thyroid storm" the metabolism, heart rate and BP shoot up due to a sudden release of thyroid hormones causing massive hyperthyroidism it can be due to a malfunctioning pituitary gland or the thyroid itself, easy to check thyroid hormone levels, the fact that she gets very hot is also an indication, heavy sweating is also common
Harley Drive
Your mom may need an echo cardiogram to help diagnose her. There are a lot of different arrhythmia's that can cause this. It could be episodes of ventricular tachycardia or supra ventricular tachycardia (most likely cause since the paramedics saw a. fib) the SVT could also be atrial tachycardia which is very common in women, but is usually transient and doesn't often manifest such Extreme symptoms. It sounds like your mom has a lot of cardiac irritability. If she drinks anything with caffeine, make sure she stops. This could be progressing and she may eventually need cardioversion or overdrive pacing. The cardiologist is probably trying to treat conservatively first until the meds no longer work. Finally, it is possibly that some of this is anxiety. Is you mom under a lot of stress right now or does she have a history of emotional problems? I just read the thyroid suggestions. I didn't think about it at first because I'm so cardiac programed as a cardiologist would be too, but your mom should definitely have a thyroid function test done!
conusgypsy
At the risk of getting lost in the sea information you have been given, I hope that you take the time to check out what ProArgi-9 could do for your mom. It contains an amino acid that produces a nitric oxide affect in the blood stream. I have many testimonials from people with some similar issues and symptom who have found complete relief AND reduced or eliminated their prescriptions drugs. Your mom is still young and she should be filled with energy and I truly believe that ProArgi-9 can get that back for her. The product is guarateed and does not interfere with any medications. I have included links to check out below. I hope this info is helpful.
lisemacfadden
Click on the link below. If you can get her to do this, it will help her tremendously. It's a shame that she's been on medications for so many years when medications do nothing but stabilize her condition and drain her bank account (or that of her insurance company). Medications aren't designed to cure anything - they're designed to do exactly what they've done for your grandmother all these years - just keep the numbers within an acceptable range. In order to solve the problem, you need to address it at the source - and the cause of high blood pressure is dehydration. This should come as no surprise when you realize that after the age of 25 our recognition of thirst begins to diminish, and by the time we reach your grandmother's age, we drink practically no water at all. Clicking on the link, you'll see where the "treatment" involves increasing her salt intake. Don't be alarmed at this. Contrary to what doctors tell you, salt does not cause high blood pressure. Click on the second link to read a few facts about salt. Doctors don't recognize dehydration as the cause of health problems unless they can charge $385 to prevent / treat it in the ER. This is why they've allowed your grandmother to go this long without so much as asking about her water intake - there's no profit in prescribing water. When you click on the first link, be sure to read everything thoroughly. I think there's something that explains adjusting the treatment for children and the elderly. Also, do NOT stop any medications without your doctor's approval.
It's Common Sense
I am sorry you and she are enduring this.... The episode that occured around 4 or 5 am is highly suggestive of a thyroid disorder. We normally release our thyroid hormone dose at this time endogenously (from our own bodies) I believe your mother should see an internist who is board certified in endocrinology, especially one who focuses on the thyroid gland. He/she can also rule out the other potential disorders such as pheochromocytoma and adrenal dysfunction. She should also be checked for anemias including pernicious anemia. Your cardiologist will know who this is in your region. I agree that this is a significant problem and needs to be managed quickly rather than simply waiting for it to evolve furthur. The runs of atrial fibrillation and hypertension alone predispose to stroke. Meanwhile, your mother must AVOID any foods which cause something we call a catecholamine release, such as chocolate, and * Coffee * Tea * Bananas * Chocolate * Cocoa * Citrus fruits * Vanilla Drugs which trigger a catecholamine release are: # Aminophylline # Caffeine # Chloral hydrate # Clonidine # Disulfiram # Erythromycin # Insulin # Levodopa # Lithium # Methenamine # Methyldopa # Nicotinic acidNicotinic acid (large doses) # Nitroglycerin # Quinidine and others Your endocrinologist may also wish to adjust some meds and add something called a beta blocker. (Something like Atenolol, Inderal, or Timolol tabs.) These appointments should be made asap. Best wishes.
chafarm123
If she has not been tested for thyroid hormone levels she should be. I concur with Harley Drive. It has all the symptoms of a thyroid storm. This type of condition is more common in the elderly. I copied the following from this website: http://thyroid.about.com/od/hyperthyroidismgraves/a/thyroidstorm.htm If you feel it has merit in your mom's case check it out for more details. "Some people with Graves' disease or hyperthyroidism -- an overactive thyroid that is producing too much thyroid hormone -- develop a condition known as thyroid storm. It's not common however; only 1-2% of patients with hyperthyroidism develop thyroid storm. During thyroid storm, the heart rate, blood pressure and body temperature can become uncontrollable high. Whenever thyroid storm is suspected, the patient must go immediately on an emergency basis to the hospital, as this is a life-threatening condition that can develop and worsen quickly, and requires treatment within hours to avoid fatal complications such as stroke or heart attack". Thyroid storm is more common in the elderly and it becomes all the more imperative she receive immediate treatment when such a episode occurs.. I wish your mom the best. It is great she has such an attentive daughter, her life may depend on it.
Bud
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