any doc or IM or endocrinologist's opinion

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Dr Sum Day

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I woke up 2am two weeks ago with tachycardia, so I went to the ER. My BP was 160/74 and my K+ was 3.2 meq/L. The ER gave me 50mg Lopressor once a day (POD?). Plus, they gave me 20 meq of K+ for 2 weeks. They did a chest x-ray and I will be getting an echocardiogram next week.

I remember earlier that day I had muscle twitches and some cramping in my forearms and maybe in my calves. I thought is was strange because I eat very healthy---high fiber, fruits/vegs, water, fish, fish oil, multivitamin just for precaution. I exercise and least 3x/wk. Oh yeah, I also eat even more K+ containing foods than in the past which was alot. Parents have hight BP but they are inactive and eat junk food and thus are overweight.

To this day, I get some twitches and tingling in the forehead and sometimes the hands and feet. Sometimes, I got tachycardia when I ate foods with higher sodium content on Sunday. Frequent night bathroom trips are annoying too.

It just doesn't seem like I would have primary hypertension. I though maybe I had some form of secondary hypertension. One doc says look into adrenal studies although this person is not my PCF. One of my PCF (P.A.) seemed insulted that I asked about it. "Your kidneys are fine" "What about adrenals? She says if my K+ turns out fine after two weeks after initial treatment, it won't be secondary hypertension. True?

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It's a little difficult to answer your questions without knowing a bit more about you...
1. How old are you?
2. What was this "tachycardia"? Did they say it was an arrhythmia? What was your heart rate? What did your EKG show?
3. Do you drink alcohol? If you drink regularly, it can make you prone to electrolyte depletion (especially K and Mg) and arrhythmias, as well as cause hypertension.
4. Did you have a heavy workout before this happened? When you exercise you can also deplete electrolytes. The muscle cramping that you had could be a sign of low Mg.

Sure, it might be worthwhile to look into other secondary causes of hypertension down the road, but not right away when you only just got diagnosed. Usually the adrenals are looked into only after it's shown that the patient has very difficult to control hypertension with persistent hypokalemia despite high doses of potassium.

The other thing is that you can't diagnose hypertension based on a single blood pressure measurement. Your BP has to be elevated on two different occasions (without being under significant stress, like during a first visit to the ER when you are extremely worried about your heart). So don't listen to the ER docs if they told you you had HTN based on a single BP. On the other hand, if your BP is still elevated in clinic (or in measuring at home), then you do have HTN.

I'm willing to bet that the reason the ER started you on Lopressor was not because of hypertension, but because of your tachycardia. If you're young, you probably had an SVT, which would explain why they want an echo. Again, because we have very limited info, I can only make a vague guess as to your situation.
 
AJM said:
It's a little difficult to answer your questions without knowing a bit more about you...
1. How old are you?
2. What was this "tachycardia"? Did they say it was an arrhythmia? What was your heart rate? What did your EKG show?
3. Do you drink alcohol? If you drink regularly, it can make you prone to electrolyte depletion (especially K and Mg) and arrhythmias, as well as cause hypertension.
4. Did you have a heavy workout before this happened? When you exercise you can also deplete electrolytes. The muscle cramping that you had could be a sign of low Mg.

Sure, it might be worthwhile to look into other secondary causes of hypertension down the road, but not right away when you only just got diagnosed. Usually the adrenals are looked into only after it's shown that the patient has very difficult to control hypertension with persistent hypokalemia despite high doses of potassium.

The other thing is that you can't diagnose hypertension based on a single blood pressure measurement. Your BP has to be elevated on two different occasions (without being under significant stress, like during a first visit to the ER when you are extremely worried about your heart). So don't listen to the ER docs if they told you you had HTN based on a single BP. On the other hand, if your BP is still elevated in clinic (or in measuring at home), then you do have HTN.

I'm willing to bet that the reason the ER started you on Lopressor was not because of hypertension, but because of your tachycardia. If you're young, you probably had an SVT, which would explain why they want an echo. Again, because we have very limited info, I can only make a vague guess as to your situation.

I am 36 y/o and do not drink alcohol (sometimes glass of wine--once in a blue moon). My BP has been around 112/72 til the event. I'm physically fit and do weights and elliptical machine. I didn't workout that day either. I was told I have a partial bundle block, which I was told in the past during my time in the military. I seem to get tachycardia at bedtime--maybe worrying? My pulse was fast like when I work-out--130 + bpm

Now, I do eat much more bananas, orange juice, raisins, etc, but still have twitches and tingling sensations. tks
 
dpw68 said:
I am 36 y/o and do not drink alcohol (sometimes glass of wine--once in a blue moon). My BP has been around 112/72 til the event. I'm physically fit and do weights and elliptical machine. I didn't workout that day either. I was told I have a partial bundle block, which I was told in the past during my time in the military. I seem to get tachycardia at bedtime--maybe worrying? My pulse was fast like when I work-out--130 + bpm

Now, I do eat much more bananas, orange juice, raisins, etc, but still have twitches and tingling sensations. tks
Definitely look into adrenals. This screams ADRENAL to me. Good luck.
 
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