Misc

[thumper21]

Hello,thanks for taking my questions.

History: Very high and hard to control blood pressure,diabetic,high cholesterol,hypothyroid and family history of heart disease.

1. What causes elevation of end diastolic pressure,
   and how is it treated? (cardiac cath done a few months back)

2. Cephalization of the pulmonary veins?


Thank You!!

[Mel22]

Wow! Thanks for anwering my question, doctor. I wasn't expecting that! ;-)

Mel

[thumper21]

MJM,
Thanks again for answering my questions.

Would the treatment change if there were mild pumonary edema?

[Mel22]

What is "end diastolic blood pressure"? Is this the same as diastolic pressure; the bottom number on the standard blood pressure reading?

Thanks

[CCF-M.D.-MJM]

It is the pressure in your left ventricle at the same time your diasolic blood pressure is being recorded.  To physicians it represents the pressure seen by your heart and lungs.  This helps us understand when shortness of breath is from the heart or other possible causes (lungs, anemia, etc.).

[CCF-M.D.-MJM]

Hello,

The two most common cause of an elevated end diastolic blood pressure are heart failure and a stiff ventricle.  You didn't mention a history a history of heart failure and your history suggests you may have a stiff ventricle.  Stiff ventricles are most commonly caused by chronically elevated blood pressure.  Your heart compensates for high blood pressure by making more heart muscle to push against the elevated pressure.  

The best way to treat this problem is to control your blood pressure.  I am sure you know the goal systolic blood pressure for a diabetic is less than 130.  This may mean taking a lot of blood pressure medications, but this is important.   Every few millimeters dropped in blood pressure equates to a decreased risk of future events.

Cephalization on pulmonary veins is a sign of an elevated end diastolic pressure.  Blood is backing up from your left heart and is more prominent in your pulmonary veins.  The treatment is the same as above.  It is important to get your blood pressure under control or you will likely develop worsening shortness of breath.

you should be on a statin medication (lipator, zocor, etc) if tolerated.

you should be on a beta blocker, diuretic, and ACE inhibitor at the very minimum, depending on other variables.

Good luck in taking care of these issue.  Weight loss will help, but the longer you wait, the more difficult it will become.  Once you start getting short of breath, exercise is more difficult.

My advice is to be aggressive under your doctors supervision to safely lose this weight!

I hope this helps and thanks for posting.