questions

[lmfao]

Hi, I'm a 33 year old male.

My biological father died 24 years ago from thoracic aortic dissection after many years of an inflammatory artery disease which I believe affected arteries in his chest. My mother is alive but has Lupus

But this is now...in the last 4 months, my chest and lower neck have started hurting chronically.  I still have a dull headache that rarely lets up as mentioned above.  

Besides my chest hurting all the time, I feel lethargic, and get dizzy frequently. I get nausea and mental confusion too.  My pulse has been doing strange things such as racing to 160 in my sleep and making me wake up choking for air...I so easily get tachycadic in my sleep and feel like im choking or dying (i had on a 30 day monitor).

I've been screened recently with EKG, 30-day monitor, Resting Echo, chest Xray, brain MRI,
and the basic labs like CBC, CMP, Liver, Cardiac enzymes, TSH, T4, Cortisol spot check, SED rate, and maybe 1 or 2 more things I can't remember.

Supine, my BP commonly drops to 90/50...my sitting or standing BP is a lot higher..typically 120/75).  I often wake up with a pulse as low at 50 in the morning.

A few questions, please:

1) What is the best test to get to check for inflammed blood vessels or thoracic aortic dissection (I assume plain Xray is not sufficient).  Would this be a Chest CT without contrast, with contrast, or MRA perhaps?

2) Does my normal SED rate rule out inflammed arteries, and what can my BP differential or 10 mmHg when supine mean?

3) Can I take 10 mg inderal to help control tachycardia/anxiety during the day with my pulse and pressure going so low during my sleep (again i sometimes wake up with pulse of 50).. ie- will the inderal wear off in time for bed if I don't take it before X number of hours before sleeping at night?

4) can you say anything else?

[Cleveland Clinic]

There are several test to look for aortic aneurysms. The test we order most commonly is a CT of the chest with contrast, although MRI of the chest or TEE are also acceptable tests. These could explain why you have a diminished right radial pulse. A normal ESR would make it very unlikely that you have an inflammatory cause of a thoraccic aneurysm, but does not rule out the most common cause of throacic aneurysms which is atherosclerosis.
I would try to find out what the specific tachycardia you are having is with a Holter monitor, because you may need more specific treatment for this ( such as anticoagulation with coumadin if it is A Fib) , and not simply take inderal as you suggest.

[lmfao]

1 other thing I meant to say is that , it seems to me that my right radial pulse at the wrist is alot harder to find than the left (feels weaker to me)