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How would you diagnose this person?

Female 70 yo has a history of high blood pressure (about 20 years) with systolic being 200-230, falling sometimes to 180 after medication (and she never gets it lower than that), but medications are not taken regularly (so most of the time she has it around 200). 2 weeks ago she started complaining about continuous pain in the heart and blood pressure fell on itself to 140 and has remained such; does not sleep well at night due to this pain, heart rate is increased, also feels lack of air. What possible conditions could correspond to these symptoms?
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Hi There. The information supplied is very small. To be honest given the circumstances, I would consider a trip to the ER. They would do an ecg and also blood work and further evaluation. The bp numbers are quit high and the normal guideline is if systolic is over 180 its time for urgent er evaluation. Dont panic but do something
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