Help? Sudden High BP and Pulse. Still having heart attack-like pain.

[danly22]

21 year old. Female. Started off with Pericarditis. Treatment went very well. Pericarditis is resolved. Suddenly, my heart rate went as high as 150s and my BP went as high as 150s/110s and refused to go down. Given Metoprolol, but the medication lowers my BP too much so I'm taking a new beta blocker.

Even though my Pericarditis has resolved, I'm still getting chest, jaw, neck, upper back pain as well as nausea and dizziness (and despite normal heart rate and BP). I checked for other factors such as pulse pressure, which seems to vary depending on position. Laying on my back results in a wider pulse pressure, while standing results in a low pulse pressure. The pain is mostly persistent, but activity seems to cause the pain and then it goes away when resting... usually. I can also feel my heart beat when laying down.

I also have the occasional shortness of breath, but it's a brief occurrence.

I just visited my cardiologist today and got a "Mostly Normal" EKG, but BP was rather low. During these past 5 months I've had plenty of EKGs, multiple echos, many chest x-rays, a lot of blood tests, and a Stress Echo. I've also been to the ER more times than anybody should within a 5 month period. All normal and with Pericarditis apparently resolved, but my symptoms remain.

My cardiologist ordered an angiogram, however, it will take about 5 business days to be approved. He's rather confident that the test will come out normal, but I'm not so sure. Is an angiogram enough to rule out any cardiac issue, including vasoconstriction?

I am getting very worried. Does my experience sound similar to angina? It is even hard for me to walk without feeling dizzy and my blood pressure rising. After many tests and trips to different ERs, I'm quite reluctant to go on another ER visit.  I'm currently having chest pain but I'm afraid I'm between a rock and a hard place.

Is there any reason for this? I am scared for what the future holds.

[tacolino]

Hi there. I am not a doctor but will offer you my help / opinion.
Firstly try not to be too scared with this.
Your ecg seems to be fine. The echo also which is good as its a test for looking at heart function/ pump function /valves.

Your symptoms of rapid heart rate combined with raised BP , should be checked for possible secondary causes. IE Adrenal issues / thyroid issues. Its rare enough but worth checking.
.Its  less likely given that you react well to the beat blocker, as often the high BP is resistant when Adrenal issues are  present. Anyway look at them  to outrule it.
( Your doc may have already included this in the blood work he did, Renin , aldosterone etc )

Given your list of symptoms, I  can see why they are doing an angio. You say the pain/ discomfort happens when you move around? Do you mean on exertion like walking / running or going up stairs? its important to clarify fully what brings it on. In Stable angina it often appears during exertion and subsides after the exertion is finished.
The out of breadth may be caused by the Tachycardia.
The nausia Dizzy feeling may be a side effect of your medication. Beta blockers tend to have side effects and often if the BP goes too low, the dizzy feeling happens, especially if you stand up suddenly from sitting.
I think you will be ok, but given your concerns, the Angio is probably a good idea, as it will give you complete reassurance regarding any angina / blockages etc.
The test is expensive and invasive, but often done through the radial in your wrist. You will be able to see the screens too if you want, and you can see the contrast dye going through the arteries. The test is painless
keep us posted, hope this helps