What Causes Difficulty In Breathing In A Hypertensive Person?

Posted on Sat, 20 Feb 2016

Question: Do I need further investigation? Now I am otherwise fine except a feeling to take a long breathe. What blood pressure medicine should I continue?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
No drugs / only follow up

Detailed Answer:
Hi friend
Welcome to Health Care Magic

Exercise ECG is normal / practically excludes Ischemic Heart Disease / reassuring

You need not take any medicine for blood pressure for the time being.
Check it up on several occasions.
Your doctor may start drug, if persistently high – the values for the upper figure 140 or above and/or lower figure 90 or above / and aim to bring it down to 130/80

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Anantharamakrishnan (1 hour later)

Thank you Doctor. I think messed up my querry and uploading of reports. So I am trying explain my position again.

I am 53 yr old. For high bp, I took atenolol 25 mg for many years. Last 2/3 yrs I was taking amlopress AT 50 mg. Just a week back in the morning, I felt a bit of squeezing or congestaion in my left chest (cant explain properly as it was not pain in clear sense) while climbing few stairs and while walking a bit of uphills. There is no chest pain, giddiness etc. I felt like tired on my leg. My weight is around 78 kgs. I was a bit tensed with the situation and visited a doc. He measures my bp as 130/80. Pulse 84/min irregular and suggested to visit a cardio. Accordingly, Cardio Doc measures bp as 170/90 and ask for ECG, Blood Test, ECHO, TMT and then HOLTER. (Reports uploaded)
Now they have prescribed Tazloc 40mg at 8 PM and tab CTD 12.5 mg at morning.
I have started tazloc...should i start CTD too.? My bp today is 140/80 as I am taking Tazloc 40.

Please give your valuable opinion on reports of ECHO, TMT, HOLTER, BLOOD etc. and also on drug of high bp.
What should I do now?

Answered by Dr. Anantharamakrishnan (6 hours later)

Brief Answer:
YES - take it

Detailed Answer:
Hi friend
Welcome to Health Care Magic

Tazloc is telmisaratn – an angiotensin Receptor Blocker (ARB
CTD is Chlorthalidone – another class (diuretic)
Either of them is first choices for treating blood pressure…

They act by different mechanisms and a combination is good
Most people need more than one drug for control.
With a long history of pressure, you must aim for 130/80 or less

So take BOTH the drugs
After a few days, when the pressure is controlled well and stable – it can be switched over to a combination product, combining both the drugs

So, the symptom does not have anything to do with heart. There is no cause for concern
ECHO and TNT are absolutely normal

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Anantharamakrishnan (3 hours later)

Thank you very much. I got lot relief from tension. Because the cardiologist here, advised me that I should go for further investigation like EPS and CAG angiogram etc. Doctor, I was also worried a bit because I could not do full 15 min of the TMT and in HOLTER report, it is written "Intermittent second degree AV block 2:1". If you please enlight me or clear the fear from my mind on the above.
Doctor, I also decided to stop smoking totally and want to control my diet a bit for my heart and weight. Will you want to suggest something or shall I ask some dietician here?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
See dietician / stop tobacco & alcohol / Repeat test

Detailed Answer:
Hi

     Short duration in TMT might be from long term lack of physical activity. Do regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week. Isometric exercise (like bull worker) is bad.
     Second degree block are two types – type 1 is generally harmless / and might have been from the atenolol, Nothing to do / repeat the Holter after a fortnight or so
     Catheterisation and coronary angiography are done only with a view for possible intervention. It is to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive and is not a routine… generally done, when there is suggestion of ischemis in TMT… TMT is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
If the patient or the physician is still in doubt, CT angio is the non-invasive study for the anatomy (structure) in such situation.
Keep your weight to normal / even a little less
     Quit smoking, if you are a smoker
NO alcohol
     Do regular EXERCISE
Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / XXXXXXX sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil. /
Yes, you should consult a dietician

To summarise, you may go for a second opinion / repeat the Holter and the TMT after a month or two – in a different centre

Good luck
Regards

Above answer was peer-reviewed by : Dr. Sonia Raina