Re: Blood Pressure

Posted By CCF Cardio MD on August 03, 1997 at 13:26:30:

In Reply to: Blood Pressure posted by Juanita on August 02, 1997 at 20:27:45:







: I was wondering if you would know why the blood pressure in my right arm
would be 212/102, and my left arm would be 147/93? I am taking tenormin
50mg a day, and procardia 20mg a day. Any information would be helpful.
                   Thankyou, Juanita.



  ____
Dear Juanita,
There are several potential reasons why there would be a disparity between the blood pressure in your arms.  The first is an error in measurement, but given the large difference(about 50mm Hg--millimeters of mercury) this is unlikely. The second has to do with a narrowing, or stenosis, of the left subclavian artery causing a decrease in blood pressure in the left arm. If this is the case, your doctor may be able to hear an audible noise over the stenosis( a bruit) with a stethoscope.  Subclavian artery stenoses are often due to atherosclerotic disease, and may be a marker for disease in other major blood vessels of the body.  
Third, it is possible, although less likely, that you have a condition known as aortic coarctation, where a narrowing, or stenosis, is present in the aorta,  before the origin of the left subclavian artery.  This problem will often result in high blood pressure, or hypertension, in areas that are prior  to the coarctation, such as the right arm. If this is the case, you will have lower blood pressure in your legs--not only you left arm.  
These conditions need to be evaluated by a physician experienced in the management of vascular disease and hypertension.  I recommend that you receive a thorough physical examination and possibly undergo ultrasound testing of the blood vessels that we discussed to rule out some of the conditions noted above.
Have a nice day.
CCF Cardio MD SM