Unexplained Bouts Of Pain, High Blood Pressure Etc.
I am posting this for my 62 year old mother who generally feels well but has bouts of a condition that causes the
-her head feel like it weighs 1000 pounds
-terrible pain in her chest and this last time the pain was also on the right side of her lower back.
-Her blood pressure spikes and her doctor puts her in the hospital, doctors have trouble stabilizing it once she gets to the hospital.
She has been hospitalized 3 times in the last 3 years. The last time she was hospitalized it took 3 days to
bring down her blood pressure which was at 180/120. Also the last time she was hospitalized in addition to chest
pain she also had extreme pain on the right side of her lower back to the point where she could not bend over.
She takes a daily dose of 20mg of Accupril and has for years. Except for when she has bouts of this condition
her blood pressure is normal and she feels and looks very healthy. The attacks come without warning and no
reason for them has been given. She feels absolutely awful when they come.
She usually walks 3.5 miles per day and has for a year and feels well.
After her last hospitalization she was sent home with Amlodipine Besylate 5MG.
Each time she was treated she had a battery of blood work (numerous vials) in an attempt to find the cause. She was checked for a heart attack and also had a stress test. None of these have pinpointed a cause.
She was also given needles to try and being down her blood pressure, I don't know the names of what they were.
The pain in her chest is below breast, by rib cage.
Each time she is sent home after her blood pressure is finally stabilized. After 6 months or sometimes a year it all comes back again without warning. The bouts seem to be coming closer together and more severe.
I agree with the workup this far, including the tests to exclude a cardiac cause.
It is difficult to know whether the blood pressure is caused by a specific disease, or as a result of the periodic episodes of pain. If it is the latter possibility, finding the cause of the pain should be a priority.
Uncontrolled hypertension can be due to a number of "secondary" causes, and can include a narrowing of the renal arteries, or problems with the adrenal gland, including a pheochromocytoma or hyperaldosteronism. Sleep apnea can also be a cause of resistant hypertension.
These options should be discussed with your mother's physician, and appropriate testing initiated if any of these conditions are suspected.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
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