stent/BP/aneurysms

[Jim-Weidner]

  Five years ago I had a triple bypass. On medication (LoPressor and Zestril) my BP has been maintained at approx 120/80. Last month, with chest pain, I had catheterization and a stent was placed into RCA (99% blockage). Now there appear to be two complications: first is two pseudoaneurysms in my leg. The doctor has adopted a wait-and-see approach to these in the hopes that they will be naturally resorbed. It has been 5 weeks now, but the large "knot" is still there in the groin and the leg gets cramps, not to mention severe pain at times ("pressure on nerve"). I have been going each week for an ultrasound and so far the aneurysm shows only a slight decrease in size.  Questions: Is this the correct approach? How long will this process take. What to do about the pain (I avoid pain killers).  Second problem seems to be that now my BP has gone up to 190/120, sometimes 170/130. My wife is an RN and nursing supervisor; so she takes it for me each day. I am still taking the meds as before, but the effect seems to be nil. Here's an odd thing, however: The other day I drank about a half pint or pint of scotch (with water), and the BP dropped from 180/120 prescotch to 120/70 postscotch an hour later. My wife could not believe it and said there must be some other mechanism operating. We repeated the "experiment" a few days later with the same results: lower BP after drinking scotch. Now, I dont advocate alcoholsim as a cure for BP (I am also taking Glipizide for mild diabetes), but how could such a dramatic drop occur? What is the relationship between alcohol consumption and BP, and why did mine drop so precipitously?
---------------------------------------------------------------------------------------------------
Dear Jim
Pseudoaneurysms that are small usually heal by themselves. This can take several weeks. Ones that are too large for spontaneous closure can be sealed with ultrasound guided compression. If this fails, surgery may be required.
Chronic alcohol use tends to raise the blood pressure. Acute alcohol  ingestion tends to lower the blood pressure;  in part, it does this by opening up blood vessels on the skin, sometimes leading to the feeling of warmth or being flushed associated with alcohol drinking. Alcohol can decrease stress in some people; stress can contribute to elevations in blood pressure. I would not recommend alcohol as a means of reducing blood pressure.
I hope this has been useful. Feel free to write back with further questions. Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.