Headache, Hypotension & Chest Pain

[AJMere]

My husband has been suffering from sporadic chest pain L of medial plane for ~4 mo...EEG, CBC/Chem, etc. all normal.  4 wks ago he suffered "minor" trauma to back  of head @ base of skull...has had a chronic non-remittant local headache since then.  As of yesterday AM headache became severe and generalized to entire head.  Neck X-ray normal, CT normal w/ minor calcification to 4th ventricle.  2  Darvocet TID did not reduce pain after 15 hours.  Nausea, photosensetivity increased throughout day.  Taste sense altered by the end of day.  Describes generalized eye pain.  BP this AM was 85/77 (Normal for him is 110/80).  Has been cold most of day, getting worse.  Temp normal.  My husband did NOT describe chest pain at admission for head/neck pain today.  Doc's do not seem concerned, just OK w/ pain killers for the rest of his life.  Can somebody offers some direction, please?

[moonmaiden]

Have a brain MRI. I had these same symptoms and it was due to a severed vertebral artery.  I was seen at the ER and referred to an ENT, but it wasn't until 2 years later that the stroke I had was found on a brain MRI. Also, that test was followed up with an MRA and it was found that the artery was totally missing! This was caused by a head injury.  I had chest pains also, prior to this injury, and all tests were normal. I still have the chest pains occasionally.  My BP went down and stayed there for years.  I am left with some severe damage due to this including severe migraine, acquired nystagmus, oscillopsia (jerking eyes), balance & vision problems, and joint aches/pain.  

[DrNoopurMD]

Hi,

Thanks for writing in.
I think your husband should undergo a complete cardiovascular evaluation including an ECG since he has been having chest pain on the left side for so long.
It is also possible that the symptoms like headache, nausea, photosensitivity and eye pain are due to migraine. Migraines have been known to get triggered by head injuries.
These symptoms can also be due to raised intracranial pressure. However since the CT scan of brain is clear the possibility is not much.
The BP needs to be restored to normal as soon as possible by increasing the fluid and salt intake. Also make sure his lower limbs are elevated above the level of heart while lying down.
Hope this helps!