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Old 06-17-2011, 03:26 AM   #1
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Episodic BP spikes -cause unknown -thoughts?

Hi! I'm new to this message board thing so please bear with me. I'm a 48 year-old white male, in generally good health, taking meds to manage cholesterol, HBP, hypothyroidism, and GAD. In February of 2010 I had an episode of a sudden spike in BP with tachycardia that landed me in the ER and subsequently ICU for 2 days of observation. BP had topped out at 177/130, heart rate was up around 140. Happened at about 2:30PM on a Friday at work, which was going well. Test results yielded no evidence of heart attack. Subsequent nuclear stress test was fine, with no sign of any arterial blockages. Was told by Docs to go about business as usual, paying attention to my diet and exercise routines (which I had been- diligently), and watching my level of stress (which is relatively low). Then on May 16th of this year, it happened again around 8:00AM. Didn't go to the ER, as the symptoms were the same but seemingly not quite as intense. I called into work, and opted to pop a Nitro tab (which had been previously been prescribed after the Feb '10 event, just in case). BP reached 161/124, heart rate topped out at 122. It took an additional Nitro tab and about 4 hours for everything to return to "normal". Stayed home that day and rested/slept. Woke up Tuesday, felt OK, so I went to work (I am a Certified Pharmacy Tech). The morning was a little busy, but I broke out into a drenching sweat which went on for about 2 hours. I know my BP was elevated, but I didn't check it. Around 11AM, things once again returned to normal. The next day, Wednesday, everything was fine- the whole day went off without a hitch, and I felt great. On Thursday May 19th, woke up, felt good, went to work. I had been at work all of 5 minutes when I felt it come on all at once. Wicked spike in BP, rapid and accelerating heart rate, weakness/dizziness, pallor, etc. I popped a Nitro, one of my co-workers called 911, and 5 minutes later I was on my to the ER again. EMT's gave me another Nitro tab, then a Nitro patch, then a low-dose of Morphine via IV, which finally started to bring everything down. BP had topped out at around 171/130, HR was 124. Again, 2 days in ICU for testing and observation. No evidence of heart attack, and another nuclear stress test came back just fine, though they did see a small spot on the lower left ventricle they couldn't identify. I then went to DHMC and underwent a heart cath, which revealed nothing. I most recently took a 24-hour urine test to check for evidence of pheochromocytoma, which came back negative. So I and my Doc are back to square one. Any thoughts, anyone? These episodes are pretty scary- I'd like to find out what's causing them!

 
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Old 06-17-2011, 09:08 AM   #2
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Re: Episodic BP spikes -cause unknown -thoughts?

Do you have any history of panic attacks or anxiety? Or are you going through menopausal symptoms possibly? I believe both anxiety and hormonal changes can have a pretty profound effect on bp.

Hang in there and I hope you get some answers.
Ivy

 
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Old 06-17-2011, 03:15 PM   #3
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Re: Episodic BP spikes -cause unknown -thoughts?

Thanks, Ivy. Can't be menopause (unless it's MALE menopause! LOL!). No panic attacks, though I began being treated for general anxiety disorder several years ago. However, my medication works great, so no problems there. Guess I'll keep looking!

 
Old 06-17-2011, 03:43 PM   #4
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Re: Episodic BP spikes -cause unknown -thoughts?

lol, sorry I missed your were a male....

 
Old 06-17-2011, 11:18 PM   #5
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Re: Episodic BP spikes -cause unknown -thoughts?

Roknroller,
You must be feeling so frustrated with all this.
Let me ask you:
Regarding pheochromocytoma, I know the 24-hour urine test for excess of catecholamines turned up negative, but ask the cardio about the "Plasma Free Metanephrine" blood test. That's a blood test that some say may be even more reliable than the urine test, especially if there is an intermittently secreting tumor.

Also, have the doctors ruled out obstruction or narrowing of the renal artery? i.e anyone suggest a renal artery scan for you?

zuzu

 
Old 06-16-2012, 10:14 PM   #6
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Re: Episodic BP spikes -cause unknown -thoughts?

Quote:
Originally Posted by roknrolller View Post
Hi! I'm new to this message board thing so please bear with me. I'm a 48 year-old white male, in generally good health, taking meds to manage cholesterol, HBP, hypothyroidism, and GAD. In February of 2010 I had an episode of a sudden spike in BP with tachycardia that landed me in the ER and subsequently ICU for 2 days of observation. BP had topped out at 177/130, heart rate was up around 140. Happened at about 2:30PM on a Friday at work, which was going well. Test results yielded no evidence of heart attack. Subsequent nuclear stress test was fine, with no sign of any arterial blockages. Was told by Docs to go about business as usual, paying attention to my diet and exercise routines (which I had been- diligently), and watching my level of stress (which is relatively low). Then on May 16th of this year, it happened again around 8:00AM. Didn't go to the ER, as the symptoms were the same but seemingly not quite as intense. I called into work, and opted to pop a Nitro tab (which had been previously been prescribed after the Feb '10 event, just in case). BP reached 161/124, heart rate topped out at 122. It took an additional Nitro tab and about 4 hours for everything to return to "normal". Stayed home that day and rested/slept. Woke up Tuesday, felt OK, so I went to work (I am a Certified Pharmacy Tech). The morning was a little busy, but I broke out into a drenching sweat which went on for about 2 hours. I know my BP was elevated, but I didn't check it. Around 11AM, things once again returned to normal. The next day, Wednesday, everything was fine- the whole day went off without a hitch, and I felt great. On Thursday May 19th, woke up, felt good, went to work. I had been at work all of 5 minutes when I felt it come on all at once. Wicked spike in BP, rapid and accelerating heart rate, weakness/dizziness, pallor, etc. I popped a Nitro, one of my co-workers called 911, and 5 minutes later I was on my to the ER again. EMT's gave me another Nitro tab, then a Nitro patch, then a low-dose of Morphine via IV, which finally started to bring everything down. BP had topped out at around 171/130, HR was 124. Again, 2 days in ICU for testing and observation. No evidence of heart attack, and another nuclear stress test came back just fine, though they did see a small spot on the lower left ventricle they couldn't identify. I then went to DHMC and underwent a heart cath, which revealed nothing. I most recently took a 24-hour urine test to check for evidence of pheochromocytoma, which came back negative. So I and my Doc are back to square one. Any thoughts, anyone? These episodes are pretty scary- I'd like to find out what's causing them!

 
Old 06-16-2012, 10:27 PM   #7
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Re: Episodic BP spikes -cause unknown -thoughts?

I know this is an old post, but I have exactly the same thing going on - BP spikes that last anywhere from minutes to hours, completely negative workup so it must be stress, but deep breathing and xanax don't help either. I'm now having really bad gastritis at the same time and feel like my body is being flooded with hormones. My BP meds have been changed 6 or 7 times in the past few months. The new meds work well for a couple of weeks and then I become borderline elevated and then start spiking. My sister found out a few months ago that the non-specific health problems she has been having for years are due to multiple food allergies including a severe wheat allergy. I guess I need to be tested for that too, as my doctor and I are out of ideas. Any suggestions?

 
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