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Heart & Cardiology/Unexplainable pain and hypertension

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Question
Hi, I have had hypertension for since I was about 11 years old, I am female, now 19 and in desperate need of a second opinion. My cardiologist doesn't have a clue as to what is causing the high blood pressure. It usually around 145/95 . The worst it has gotten was when I ended up in the ER with a bad headache and blood pressure 179/125. I have had my thyroid hormones checked and though I had problems with them earlier they all came back ok,my kidney were also checked and it's all good. I have had pain under my left breast for the past six months or so and have had a weird felling like a butterfly was in my chest.I have had an ECG holter monitor for 24 hours and it said this:


Summary of holter events :

The average heart rate was 89 bpm.The minimum heart rate was 52 bpm.The maximum heart rate was 150 bpm. Total QRS count for this recording was 125.802. There were 1.368 artifact triggers which represent (1,1%) of the total QRS count.

The patient has 1 marker initiated during the test.


There were no PAC beats.
There were no PVC beats.

There were 151 episodes of tachycardia rhythm, the duration of the longest tachycardia was 1 hour 27 min and 51 sec.

There was one episode of Absolute Arrhythmia (using RR variation >20%)detected. The maximum episode was 1 per hour lasting 00:01:15 secs.

No ST depression episodes were detected.

I am yet to take this to my doctor. Please help I need another opinion, I think that I am too young to be on medication all the time.
Best Regards, Dajana

Answer
Hi,

At your age and with the symptoms described it is very unlikely that you have concerning heart disease. Have you had an echocardiogram at any point as if that was normal it would be reassuring. Your holter monitor results are pretty much normal which is good. In terms of being on medication for blood pressure, i would advise the following, and i think you are right to be cautious given your young age. Firstly keep a blood pressure diary, you will need to buy a monitor, and check it a few times a day after sitting for 5 minutes and see the pattern over time, it is an average of reading and not a single reading that is most effective before making treatment decisions. Also if you are determined to have high blood pressure then i would recommend lifestyle and diet changes as an initial treatment approach.

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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