Communicating with Doctors: Heart and Lung Function Tests for Hypertension

Q: Communicating with Doctors: Heart and Lung Function Tests for Hypertension

Dear Mr. <br>Shih Ping-Ming： Our hospital (Hsinchu Hospital, Department of Health) has been offering a cardiology education clinic every Tuesday evening from 6：30 PM to 8：30 PM since January of the 90th year. <br>Dr. <br>Po Shih-Chun will be available for consultations to provide

Cardiopulmonary function tests and cardiovascular diseases?

Dear Dr.
Ke,
I have been suffering from hypertension for many years, and in the past, I also had hyperlipidemia, arrhythmia, gastric ulcers, Helicobacter pylori infection, urinary tract infections, and ureteral stones.
Except for hypertension, all other conditions have been treated successfully.
Since May of this year, I have stopped taking antihypertensive medications that I used to rely on daily.
However, in the past month, I have frequently experienced chest tightness and headaches.
When I measured my blood pressure myself, I found that my diastolic pressure remains elevated.
Due to work commitments, I am unable to return to the hospital during outpatient hours for treatment, so I have been purchasing antihypertensive medications from the pharmacy on my own.
Recently, I often feel short of breath even when carrying light items.
In the past, I have undergone tests such as electrocardiograms, echocardiograms, and exercise stress tests, but the results were deemed normal by the outpatient physician.
Tonight, I was able to visit the hospital due to a day off, but the outpatient doctor was unwilling to prescribe any antihypertensive medications or conduct biochemical tests (despite my fasting for over eight hours).
Therefore, I would like to seek your advice on how to communicate with the outpatient physician regarding a more comprehensive cardiopulmonary function assessment and the adjustment of appropriate antihypertensive medications.
It seems that such tests usually require prior appointments.
Since I truly cannot make it to the hospital during outpatient hours, how should I describe my situation if I wish to switch to another hospital to receive the help I need?
Thank you for taking the time to respond, and I wish you peace and joy.

Shi Bingming, 30~39 year old female. Ask Date: 2000/12/25

Dr. Ke Zhengchang reply Internal Medicine

Dear Mr.
Shih Ping-Ming: Our hospital (Hsinchu Hospital, Department of Health) has been offering a cardiology education clinic every Tuesday evening from 6:30 PM to 8:30 PM since January of the 90th year.
Dr.
Po Shih-Chun will be available for consultations to provide you with detailed explanations and arrange for examinations.

Reply Date: 2000/12/25

More Info

When communicating with your healthcare provider regarding hypertension and the need for comprehensive heart and lung function tests, it is essential to be clear and assertive about your symptoms and concerns. Given your history of hypertension, hyperlipidemia, arrhythmia, and recent symptoms such as chest tightness and headaches, it is crucial to advocate for your health effectively.

Key Points to Discuss with Your Doctor:
1. Symptom Description: Clearly articulate your symptoms, including the frequency and severity of your chest tightness and headaches. Mention how these symptoms have impacted your daily life, especially your ability to perform physical tasks without experiencing shortness of breath.

2. Medication History: Explain your recent decision to discontinue antihypertensive medications and the reasons behind it. Emphasize that you have been self-managing your blood pressure and that you are concerned about the implications of high diastolic readings.

3. Previous Tests and Results: Reference the heart tests you have undergone, such as electrocardiograms (ECGs), echocardiograms, and exercise stress tests, and mention that the results were deemed normal. However, express that your current symptoms warrant further investigation despite previous normal findings.

4. Request for Comprehensive Evaluation: Politely request a more thorough evaluation of your heart and lung function. This could include tests such as:
- Pulmonary Function Tests (PFTs): To assess lung capacity and function, especially since you are experiencing shortness of breath.

- Holter Monitor: To monitor your heart rhythm over 24-48 hours, which can help identify any arrhythmias that may not have been captured during previous tests.

- Echocardiogram: A repeat echocardiogram may be warranted to assess for any changes in heart structure or function since your last test.

5. Discuss Medication Options: If the doctor is hesitant to prescribe antihypertensive medications, ask about the rationale behind this decision. Inquire about alternative medications that may be more suitable for your current health status, especially considering your history of side effects or interactions with other medications.

6. Follow-Up Plan: Request a clear follow-up plan. If the doctor is unable to provide immediate assistance, ask for a referral to a specialist, such as a cardiologist or a hypertension specialist, who can provide a more comprehensive assessment and management plan.

If You Consider Changing Providers:
If you decide to seek care at another facility, be prepared to explain your medical history succinctly. Here’s how you can frame your situation:
- Introduction: "I have a history of hypertension and related health issues, including hyperlipidemia and arrhythmia. Recently, I have been experiencing chest tightness and headaches, which have raised my concerns about my heart health."

- Previous Care: "I have undergone several heart function tests, which were normal, but my symptoms have persisted. I previously managed my hypertension with medication but stopped recently due to side effects."
- Request for Help: "I am looking for a comprehensive evaluation of my heart and lung function and would like to discuss appropriate medication options to manage my hypertension effectively."

Conclusion:
It is vital to be proactive in your healthcare. If you feel that your concerns are not being addressed, do not hesitate to seek a second opinion. Your health and well-being should always be the priority, and effective communication with your healthcare provider is key to achieving that. Remember to document your symptoms and any changes in your condition to provide a clear picture of your health status during consultations.

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