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Old 05-11-2012, 01:12 AM   #1
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Stroke from Low Blood Pressure

A little background. My mother, who is doing home peritoneal dialysis, had been having chest pains lately. After some sort of test, she was diagnosed with Acute Angina and scheduled for coronary stent surgery. She's had high blood pressure for years. She was taking Amlodipine, Losartan, and Furosemide and was just given her fourth BP lowering med, isosorbide for the angina pains. The procedure went very well except the surgeon was going to clear up some PAD issues after the coronary stenting but her BP had dropped to low. They keep her 2 nights until her bp had gone up enough. So she's home, we're both happy just waiting for the strength to return. About a month goes by and one morning i can tell right away something happened. She couldn't finish a sentence, no slurring, no motion problems. Just trouble coming up with the name of common objects. The first thing i do is call the Nephrologist because everything has to get cleared by them. The nurse asked me to read of the last 2 weeks bp's. Mind you I don't really know what a dangerously low bp number is. I think i got to a point that had 68 for the first number and she stopped me and went to talk to the doctor. She tell's me to take away all Mom's BP meds, make her drink salty broth and monitor her for a couple days. after a couple of days a call them and state the confusion has no change and the BP has not risen but it's not falling. So they give us Midodrine to raise the bp and tell me to monitor her for a few more days. after a day i just couldn't ignore the confusion issue and took her to her general practitioner who scheduled non contrast CAT scan. It came back with aphasia and a 70% blocked femural artery (The other side had been cleaned 7 years earlier, well we new of the 70% blockage for years so it wasn't any worse. Still, he sent us to vascular surgeon who has us take a contrast CAT scan. He shows us the scan and point out about 8 small strokes the we didn't know of. he's more concerned about where these came from because he doesn't believe the blockage is that bad. He sends us out for MRI and called us when he got the results. the latest aphasia areas were exactly mirrored on both hemispheres which means it wasnt a clot or a bleeder. The only thing left causing bilateral damage would be systemic. Most likely the low blood pressure was the cause of the stroke. what I don't get is that even with her water pills she swells. now they've taken all bp medicine away. No swelling, blood tests are great. she's lost 10 pounds. but still riding in the 70's bp most mornings. I sure would like to know what happened. Checked her bp averages and a two week period right before the surgery is where her bp dropped 25 pt average and stayed there. No med changes. she did get a new Peritoneal cycler around that time. Any Ideas would might give this worried son a decent nights sleep. Thanks to all for even reading this.

Regards,

ChuckT

 
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Old 05-11-2012, 03:43 AM   #2
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atengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB Useratengnr HB User
Re: Stroke from Low Blood Pressure

Well, hypotension in someone with carotid stenosis could cause is a stroke because of the impaired flow reserve cause by the stenosis. Whether 70 systolic is low enough to cause the stroke in a person with carotid atherosclerotic disease, Im not sure. Her doctor might be able to discern this based upon where the strokes occurred.

This sort of hypotension is possibly due to more fluid being removed from her body during her dialysis. Did they adjust the content of her dialysis fluid??

Last edited by atengnr; 05-11-2012 at 03:45 AM.

 
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low blood pressure, peritoneal dialysis, stroke



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