Sudden Left Arm Numbness and Blood Pressure Spikes

Soreness and numbness in the inner side of the left arm, along with a sudden increase in blood pressure?

Hello Dr.
Wu, for the past two weeks, I have occasionally felt numbness and tingling in my left arm, particularly concentrated in the inner side of the upper arm.
However, last night while resting in bed, the numbness in the inner side of my left arm suddenly intensified within a short period (about 1-2 minutes), becoming very uncomfortable.
I could clearly feel the discomfort in my left arm.
At that moment, I measured my right arm blood pressure, which was approximately (165/102) with a heart rate of (110).
Since the numbness in my left arm persisted and extended to my little finger and ring finger, I also began to feel some discomfort in the back of my head.
When I measured my left arm blood pressure within a minute, it had reached about (200/115) with a heart rate of (122), and I started to sweat a bit.
I immediately took a heart medication.
The numbness in the inner side of my left arm began to decrease after about 10 minutes, but it was still noticeably present.
After about an hour, my blood pressure dropped to around 155-160.
I still have numbness in my left arm today.
An electrocardiogram last October and this January was normal, and the doctor mentioned that an ultrasound in January showed mild mitral valve insufficiency with slight regurgitation (I didn't catch the exact term), and that it should be monitored.
My usual resting blood pressure is around 135-145, and when I get up to do light household chores like hanging clothes or washing dishes, it sometimes rises to 150-155, but it returns to my usual resting blood pressure afterward.
I am currently not taking any antihypertensive medication, but occasionally my blood pressure rises to the 160s for unknown reasons.
As I type this, I still feel slight numbness in the inner side of my left arm.
What would you recommend regarding these symptoms? Thank you for your patience in reading this lengthy message!

Mr. Wu, 40~49 year old female. Ask Date: 2022/01/22

Dr. Wu Xueming reply Cardiology

It is recommended to adjust your daily routine, engage in regular exercise, and avoid excessive salt intake in your diet.
If blood pressure remains elevated, it is advisable to visit a clinic for a physician to adjust your medication.
As for the issue of arm numbness and tingling, further evaluation by a neurologist may be necessary.

Reply Date: 2022/01/22

More Info

Sudden left arm numbness, especially when accompanied by spikes in blood pressure and heart rate, can be concerning and warrants careful evaluation. Your symptoms, particularly the numbness radiating from the upper arm to the fingers, along with the significant fluctuations in blood pressure, could indicate several potential underlying issues.

Firstly, the left arm numbness could be related to a neurological issue, such as a pinched nerve in the cervical spine or thoracic outlet syndrome. These conditions can cause referred pain or numbness in the arm, especially if there is compression of the nerves that innervate the arm. However, given the acute nature of your symptoms and their association with elevated blood pressure and heart rate, it is crucial to consider cardiovascular causes as well.

The sudden spike in blood pressure (up to 200/115 mmHg) and increased heart rate (122 bpm) during the episode could suggest a stress response, possibly related to anxiety or pain. However, it could also indicate a more serious cardiovascular event, such as angina or even a myocardial infarction (heart attack), especially since you mentioned a history of mild mitral valve regurgitation. While your previous echocardiograms showed only mild issues, any change in symptoms or new onset of discomfort should be taken seriously.

The fact that the numbness extended to your pinky and ring fingers is particularly noteworthy. This distribution can sometimes suggest involvement of the ulnar nerve, which can be compressed at the elbow (cubital tunnel syndrome) or at the wrist (Guyon's canal syndrome). However, given your symptoms' acute onset and the accompanying hypertension, a cardiovascular evaluation is essential.

Here are some recommendations based on your symptoms:
1. Immediate Medical Evaluation: Given the acute nature of your symptoms, especially the significant blood pressure spikes and the numbness, it is advisable to seek immediate medical attention. An emergency department visit may be warranted to rule out any acute cardiovascular events.

2. Cardiovascular Assessment: A thorough cardiovascular evaluation is essential. This may include repeat electrocardiograms (ECGs), echocardiograms, and possibly stress testing to assess for any ischemic changes in the heart.

3. Neurological Evaluation: If cardiovascular causes are ruled out, a neurological assessment may be necessary. This could involve imaging studies such as an MRI of the cervical spine to check for any nerve compression.

4. Blood Pressure Monitoring: Regular monitoring of your blood pressure is crucial, especially since you have noted fluctuations. Keeping a log of your readings can help your healthcare provider understand the patterns and triggers of your hypertension.

5. Lifestyle Modifications: While awaiting further evaluation, consider lifestyle changes that can help manage blood pressure, such as reducing salt intake, engaging in regular physical activity, and managing stress through relaxation techniques.

6. Medication Review: Discuss with your healthcare provider the possibility of starting antihypertensive medication, especially if your blood pressure remains elevated consistently.

7. Follow-Up: Ensure you have a follow-up appointment with your healthcare provider to discuss your symptoms and any findings from the evaluations.

In summary, your symptoms of left arm numbness, elevated blood pressure, and heart rate are concerning and should be evaluated promptly. While there may be benign explanations, the potential for serious cardiovascular issues necessitates immediate attention. Please prioritize seeking medical care to ensure your health and safety.

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