What Should Incase Of Chest Pain,dizziness,headache,sweating With Vomiting?

Posted on Sat, 1 Feb 2014

Question: Hi: Trying to figure out if I should be going to the hospital. Just saw my MD. My blood pressure reading in left arm was 90/60 and the right arm 132/86. From what I'm reading, that is very high risk for heart attack. My MD just gave me the name and number for vascular surgeon, but it is Saturday and I don't know when I'll be able to see him.FYI, I have always had lower blood pressure reading (112-118 over 70-80ish. Then again, they have always taken the reading from my left arm which is the one that is currently reading very low at 90/60.

Answered by Dr. Vivek Chail (53 minutes later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read your query in detail. If you are having chest pain, dizziness, headache, sweating or vomiting then you should not delay in contacting the vascular surgeon. If he isnt available for consultation, you may talk to him over phone and book the earliest appointment with him. Further it is important that you get yourself seen at the ER and investigations like EKG and if required, chest X ray and echocardiography done. Basic blood tests for heart disease may also need to be done. If you DO NOT have chest pain, sweating, dizziness and palpitations, still I would suggest you to talk to the vascular surgeon on phone and inform him of your condition. It is also possible that due to an error, there might be difference in blood pressure recordings, this must be clarified. Blood pressure is ideally recorded at least 30 minutes after a person is in a resting state. The arm should be kept at the level of the heart for measurement of the correct blood pressure. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (15 hours later)

Thank you, Doctor, for your response. No current chest pains or perspiration. Only severe dizziness accompanied by nauseousness. Turning my head in certain directions seem to exacerbate symptoms. However 2+ months ago, rushed to hospital with chest pains. EKG showed abnormalities, but subsequent blood work and echo showed no issues. I agree with your (and my own doctor's) suggestion that I see a vascular surgeon. The question is, can I afford to wait to get into him (e.g. it is Sunday and I don't know how quickly I can get on his calendar) or do I need to go the Urgent Care or Hospital for a more immediate evaluation? XXXXXXX

Answered by Dr. Vivek Chail (5 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX, Thanks for writing back with an update. If you have got investigated for chest pain and echocardiography showed no abnormality (though you write that EKG at that time was abnormal), then there should not be any worry as far your cardiac function is concerned. The severe dizziness and nausea must be evaluated in detail. There can be many reasons for your symptoms ranging from blood supply to your brain, your brain function itself and any thing to do with your vestibular apparatus (inner ear). As there was difference in blood pressure recorded in your arms and also you report that turning your head in certain directions exacerbates your symptoms, the blood supply to your brain is the one that must be investigated first. This may involve tests like carotid and vertebral arteries Doppler or CT angiogram as felt necessary by your doctor. I suppose you can keep the vascular surgeon informed and request for an early appointment. In my country, a patient with symptoms as you have is usually seen by a vascular surgeon within a couple of days. If you feel severely nauseated and dizzy, please go to your hospital and take immediate medications for symptomatic relief. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar