7 mts post MI - BP creeping up, Avg Pulse = 105

[toby45]

I'm looking for some guidance please. After my heart attacks 7 mts ago I was slowly getting better. Now, for the last month my BP has gone up from 120/72 and pulse at 70 to the new readings of BP at 134/88 and pulse avg. at 107.

I'm 45, had stents after 100% blockage of LAD and emergency angioplasty. LCA and RCA showed partial blockages of 30% but nothing was done about it.

I tire easily and if I have a 14-16 hour work day, it takes me 2 or 3 days to recover.

I'm taking Metoprolol (25mg); Lipitor; Asprin;Plavix;Niaspan;Dilantin (separate condition)....Is the high heart rate something I should be concerned about? The Cardio and primary care physician are not worried.

But I've been down a misdiagnosis road before, and concerned that the numbers are not tracking in the right direction. I get "discomfort" on the left side of my chest when i'm stressed out, and some "rods" and "pin pricks" of pain....am I being a worry wort?

I hate going to the doctors with these complaints and then being dismissed with "don't worry about it, you're doing fine!"

Thanks in advance for any advice from people on this forum who've been down this crazy road.

[maggiemag]

That is a low dose of Metoprolol, and I do not see where you are on an ACE inhibitor, which I believe are part of the MI guidelines.  The beta blocker of course can make you tire easily.  A 14-16 hour work day sounds a bit much to me........no wonder it takes 2 or 3 days to recover!  Maybe you can try to cut back some?  Your heart rate isn't that high, but higher than I would expect.  I am not a doctor, though, but I would see about getting the beta blocker increased and add an ACEI.  I suspect the rods and pin pricks are not cardiac related but the other discomfort could be.  Perhaps you need a second opinion.  See what any others have to say.

[kenkeith]

I agree with maggiemag...reading your post it appears the underlyiong cause for your prior MI is coronary artery rleated.  When there is an occlusion (the narrowing of vessels due to plaque) causes an increase of bp and higher than normal hr (compensation to increase cardiac output) due to the higher than normal resistance the heart has to pump against.  Usually, the left ventricle enlarges as well to provide more capacity and stronger contractions.

As stated an ACE inhibitor is usually recommended as that medication will/should dilate your vessels thereby reducing the heart's workload. As result there can be  (reduced L. ventricle size if dilated), and slower heart rate.  Also, some bata blockers have an ACE inhibitor characteristics as well for hp..