Blood Pressure Changes and Chest Pain: When to Seek Help

Blood pressure issues

I have a habit of measuring my blood pressure in the morning and evening, and it has typically been in the range of 100-120/70-90.
Recently, I have been experiencing unexplained pain in my left shoulder, left chest, left arm, and armpit.
The pain is quite noticeable, and I occasionally feel chest tightness.
My blood pressure readings have changed to 85-90 systolic over 60-80 diastolic, with pulse pressure sometimes around 15-20.
My pulse rate remains between 60-100, occasionally reaching below 110, but the pulse pressure is quite low.
I have had an electrocardiogram (ECG) that was normal, and my blood tests showed total cholesterol at 222, low-density lipoprotein (LDL) cholesterol at 157, and vitamin D at 18.9 (which is low), while the rest of the results were normal.
Should I seek further evaluation? I usually go to bed at 11 PM, have regular meals, and maintain a habit of walking for exercise.

Lin Yu-der, 30~39 year old female. Ask Date: 2023/09/29

Dr. Li Shengkai reply Cardiology

Blood pressure is normal; if you measure an unusually high or low reading compared to your usual levels, it is recommended to rest and measure again.
If blood tests show elevated lipid levels, dietary adjustments along with exercise can help lower them.
If you continue to experience chest discomfort or pain, you should visit a cardiology clinic, where the physician will arrange for further examinations (such as a stress echocardiogram or cardiac ultrasound, etc.).

Reply Date: 2023/09/29

More Info

When it comes to understanding blood pressure changes and associated symptoms like chest pain, it is essential to take a comprehensive approach. Your reported symptoms of left shoulder, chest, and arm pain, along with occasional chest tightness, warrant careful consideration, especially in the context of your fluctuating blood pressure readings.

Firstly, your blood pressure readings have shown a significant drop, with systolic values ranging from 85 to 90 mmHg and diastolic values between 60 and 80 mmHg. These values indicate hypotension, which can lead to inadequate blood flow to vital organs and may explain some of your symptoms, such as dizziness or chest discomfort. A normal blood pressure range is typically around 120/80 mmHg, and values significantly lower than this can be concerning, particularly if they are accompanied by symptoms.

The pain you are experiencing in your left shoulder, chest, and arm could be indicative of several conditions, including musculoskeletal issues, referred pain from the heart, or even anxiety-related symptoms. Given your history of fluctuating blood pressure and the presence of chest pain, it is crucial to rule out any cardiac issues. Although you mentioned that you have had a normal electrocardiogram (ECG), it is important to remember that an ECG does not always capture transient ischemic events or other underlying conditions.

In your case, it would be prudent to seek further evaluation from a healthcare professional. A cardiologist may recommend additional tests, such as a stress test or echocardiogram, to assess the heart's function and blood flow more thoroughly. These tests can help determine if there are any underlying coronary artery issues that could be contributing to your symptoms.

Additionally, your cholesterol levels, particularly the low-density lipoprotein (LDL) cholesterol at 157 mg/dL, are above the recommended levels, which could increase your risk for cardiovascular disease. It may be beneficial to discuss lifestyle modifications and potential medication options with your healthcare provider to manage your cholesterol levels effectively.

Regarding your lifestyle, maintaining a regular exercise routine and a balanced diet is crucial. However, if you are experiencing significant pain or discomfort, it is advisable to modify your activities accordingly and avoid any strenuous exercise until you have been evaluated by a healthcare professional.

In summary, given your symptoms of chest pain, shoulder discomfort, and the recent drop in blood pressure, it is essential to seek medical attention promptly. A thorough evaluation will help determine the underlying cause of your symptoms and guide appropriate treatment. Remember, it is always better to err on the side of caution when it comes to matters of heart health.

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