Should I be concerned with my pulse pressure?

[mrblue12]

Hello,

I'm a 28 year old, 5ft 8in Caucasian male. I'm not taking any prescription medication, nor have I been diagnosed with a heart condition previously.

I'm an ex–smoker, and I weigh 144lbs.

The reason why I'm concerned about my pulse pressure is because in Summer 2017 I had quite a few symptoms related to my heart.. I was experiencing frequent chest pains around that time. One day after going to the gym, I came back and my heart felt awful. I could hear every beat in my neck and I was also experiencing frequent palpitations. I could also easily see my pulse in my carotid artery and in my stomach. I also had presyncope.

I went to the doctor about my heart problems, and while I was there I remember using blood pressure machine in the lobby. My systolic pressure was around 120 but my diastolic was around 35! I thought it was surely a mistake so I bought two blood pressure monitors; one for the wrist, and one for the arm. Both confirm my diastolic pressure was low, albeit higher than 35. They said it was just under 60.

My doctor ordered a 12 lead ECG which showed poor progression of the right ventricle, and p wave inversion in V1, and 24 hour ECG which showed nothing significant except a few isolated supraventricular ectopics. Finally, my doctor orderd a blood test for B-type natriuretic peptide, which came back as 31 ng/l.

My doctor said "We can't keep looking for a problem." Which I completely understand. I wasn't completely happy because I was still having symptoms, but I understood her position on the matter.

Some of these symptoms have been continuous pretty much from then until now. Although, their severity has lessened. Up til a weeks or so ago, I had completed stopped having chest pains. I could still hear my heart beat occasionally but the presyncope has completely gone.

I'm concerned because it would appear the chest pains are returning, and my pulse pressure seems to be increasing again. As of today, my blood pressure was 130/65. Surely that can't be normal can it? I'm concerned that my heart isn't getting enough oxygenaded blood because my diastolic pressure is so low. I heard the arteries that provides blood to the heart tissue are filled during diastole.

Could anyone shed some light onto possible causes of my current heart problems? Should I be concerned about my pulse pressure? I'm concerned that it's a problem with the right side of my heart because of the 12 lead ECG results. My current theory is my left ventricle has a diminished preload which is causing it to beat forcefully to try compensate for the decreased amount of blood. Obviously, I'm not a doctor, but would that explain the increased pulse pressure, the visible carotid pulse, and the decreased diastolic pressure?

I have an appointment with the doctor in two weeks, but I'm concerned they will say they've already looked into this problem.

Thank you for reading my post.

[MichaelJH Heart Star]

Hello and welcome to the forum! Your blood pressure seems absolutely fine to me although obviously I am a mere engineer and scientist! See how you get on with your GP. If you feel concerned you could consider seeing a cardiologist privately (if you post your nearest major city or county you may get some recommendations). Typical cost is £200 - £250 but I and others have found it well worthwhile. After you may have to make some decisions but advice is always here!

[mrblue12 in reply to MichaelJH]

Thanks for responding.

If it weren't for the other symptoms such has palpitations and chest pains, I wouldn't be as concerned about my blood pressure / pulse pressure. But having these symptoms at the same time just makes me feel concerned.

[MichaelJH Heart Star in reply to mrblue12]

I followed up my initial consultation by a private angiogram a few days later as otherwise it would have been a four month wait! The consultant also prescribed anti-anginal medication that made a huge difference. Unfortunately I did not have the funds to go privately otherwise I could have had my bypass with weeks!

[mrblue12 in reply to MichaelJH]

How much did your private angiogram cost?

[MichaelJH Heart Star in reply to mrblue12]

About £1000 with blood tests, etc. before. But it is something to discuss with the cardiologist when he assesses your symptoms. I was experiencing severe angina at times. The breakfast after and the lunch I had before I went home were excellent!

[Kristin1812 Heart Star in reply to mrblue12]

Do think carefully about going privately. Although you get a quick appt, the time you want and the person you want, in some places the communication is not good between the two services,

I went privately after waiting too long for a Cardio appt on the NHS. He did an echo, said my heart was fine. I had a HA three weeks later with 2 stents.

There was no record available to the NHS of the private echo I had done and only a sketchy letter I had a copy of saying I was fine.

Just worth checking. Other places might be different.

It cost me £600.

[mrblue12 in reply to Kristin1812]

Thanks for responding.

To be honest, I don't have the money to go private, so there was no chance of going private anyway.

I don't think an echo can see a potential heart attack looming. As far as I know, HAs are caused by blockages to the coronary arteries, while echos look at the structure and the ejection fraction.

[Kristin1812 Heart Star in reply to mrblue12]

You’re right, of course! But my beef was that he wrongly assessed me as needing only an echo. The NHS has been marvellous to me.

[Hidden]

Reading what you say, it's hard to believe that you and your GP (?) are so clued up and are well ahead. So are you looking at HF? I noticed there are different NP tests to have.

I often find it so depressing that the government's policy on CVD revolves around patients, who have high cholesterol/High BP. If I was wrong to say this, I would be interested to stand corrected. I have not checked NICE guidelines yet.

There have been some comments on this hub that these "lifestyle" (sometimes, genetic in origin) patients are clogging up in the system so much, no other patients are given enough attention (i.e. investigation, clinicians time and money) whilst NHS resources should be allocated to different patients, equally, not only to patients, who had high lipid/high BP.

You do not need to have high lipids or high BP and you can still die from/suffer from the consequences of having CVD crisis. There are numerous other high-risk factors, besides BP and lipids.

gov.uk/government/publicati...

Good luck in your search for an answer.

[mrblue12]

There does seem to be a shift in opinion of many doctors about the role of dietary fat intake in regards to heart disease. I was watching a retired coronary surgeon on YouTube the other day saying 70% of the patients he treated at normal or lower levels of cholesterol at the time of admission. If cholesterol was truly the cause of heart disease, this simply shouldn't have been the case.