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Heart Disease (Expert Forum)
High Diastolic BP Reading close to Systolic and more questions
Answered by
Cleveland - OH
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High Diastolic BP Reading close to Systolic and more questions
by jmcruz, Apr 22, 2004 12:00AM
Dear Dr.,
Today I had a 1rst reading of BP, left arm, of 118/98.Then in right arm, 127/77, after, left arm again,
128/82. I was feeling perfectly normal, no pain, not lightheadness, neither dizziness, etc.
My related questions are:
1–Should I consider the 1rst reading an artefact/out of concern (I use a fully automatic electronic device)?
2- If, hypothetically, that reading is true, feeling normal, as it a cardiovascular relevant meaning?
Other BP/HR questions:
3 - How usually do the BP and heart rate change during a heart attack? (for example in silent HA without symptoms)
4 – Despite the normal range of SBP and DBP, some ancient physicians also consider the relation
SBP = (2xDBP) – 20 for proportional evaluation. Have you any comments on this?
Finally, a question about angina/heart attack pain:
5 - In a person with all non invasive heart exams normal (blood and urine tests, EKG, threadmill stress test, echocardiogram and Holter), caucasian male 38 y, healthy, when does he must suspect and act thinking about heart attack in a small pain in the left chest area ?
(A nearly insignificant pain, not a center chest pain, don't get worse with exercise, no other symptoms - What are the probabilities that the pain are related to heart ischemia ? )
Thanks a lot
Today I had a 1rst reading of BP, left arm, of 118/98.Then in right arm, 127/77, after, left arm again,
128/82. I was feeling perfectly normal, no pain, not lightheadness, neither dizziness, etc.
My related questions are:
1–Should I consider the 1rst reading an artefact/out of concern (I use a fully automatic electronic device)?
2- If, hypothetically, that reading is true, feeling normal, as it a cardiovascular relevant meaning?
Other BP/HR questions:
3 - How usually do the BP and heart rate change during a heart attack? (for example in silent HA without symptoms)
4 – Despite the normal range of SBP and DBP, some ancient physicians also consider the relation
SBP = (2xDBP) – 20 for proportional evaluation. Have you any comments on this?
Finally, a question about angina/heart attack pain:
5 - In a person with all non invasive heart exams normal (blood and urine tests, EKG, threadmill stress test, echocardiogram and Holter), caucasian male 38 y, healthy, when does he must suspect and act thinking about heart attack in a small pain in the left chest area ?
(A nearly insignificant pain, not a center chest pain, don't get worse with exercise, no other symptoms - What are the probabilities that the pain are related to heart ischemia ? )
Thanks a lot
Doctor's Answer
by Cleveland Clinic, Apr 22, 2004 12:00AM
, Apr 22, 2004 12:00AM
jose:
1) I would consider it of no concern as an isolated reading.
2) No. I would not change anything based on a single isolated reading. Even in the setting of a normal heart, low pulse pressure carries little significance.
3) Usually, they both increase unless the amount of myocardium is jeopardized enough to markedly impair ventricular function to cause shock (low BP) or cause electical disturbance like heart block (low HR)
4) The ancient physicians used to consider blood letting to elimate bad humors and ancient astronomers had formulas proving the earth flat. Some of the things we do today will seem silly in the future. However, with this particular issue, I would not get too hung up on the relationship between diastolic and systolic pressures.
5) Without exmaining you and your data it's impossible to tell. In a normal, healthy patient with no risk factors a chest pain syndrom (syndrome) that is ongoing before and after that evaluation is less likely to be ischemia then in someone with multiple risk factors. From the factors you mention the prior situation seems to be the case. Anytime pain seems out of the ordinary from previous episodes that have been evaluated or just worries you, you should speak to your physician.
good luck
1) I would consider it of no concern as an isolated reading.
2) No. I would not change anything based on a single isolated reading. Even in the setting of a normal heart, low pulse pressure carries little significance.
3) Usually, they both increase unless the amount of myocardium is jeopardized enough to markedly impair ventricular function to cause shock (low BP) or cause electical disturbance like heart block (low HR)
4) The ancient physicians used to consider blood letting to elimate bad humors and ancient astronomers had formulas proving the earth flat. Some of the things we do today will seem silly in the future. However, with this particular issue, I would not get too hung up on the relationship between diastolic and systolic pressures.
5) Without exmaining you and your data it's impossible to tell. In a normal, healthy patient with no risk factors a chest pain syndrom (syndrome) that is ongoing before and after that evaluation is less likely to be ischemia then in someone with multiple risk factors. From the factors you mention the prior situation seems to be the case. Anytime pain seems out of the ordinary from previous episodes that have been evaluated or just worries you, you should speak to your physician.
good luck
