BP measurement

Sharing my experience this morning - went for an echo - as far as I could tell it all seemed same as last time - then as soon as done, echo tech said, now I'm going to take your BP.  Tech instructed me to rise from my prone position and sit on the side of the exam bench with my feet dangling, arm resting on bench beside me. It went downhill from there - there were implications - no, make that statements - that I wasn't going to be able to go home given my high BP reading - this is certainly a way to NOT bring someone's BP down.  Now back at home doing multiple measurements after this anxiety-inducing event, I am in the just-fine range with my (tested against the doc's office) home monitor.  I wouldn't expect the echo tech, who seemed very capable as an echo tech, to also be a BP measuring expert, but this whole approach seems very odd.  I have a follow up with doc already scheduled to happen soon, and I know I need to take this very seriously and I do, but why can't we just have a few more moments for stillness, be provided a chair for some support at the back, allowed to have feet firmly on the floor, and forearm about waist level - is this so challenging in the current cardiogist practice environment that it is easier for them to just call an ambulance to get me the heck out of there?  Very frustrating.


6 Comments

bp measurement

by new to pace.... - 2021-10-14 17:21:37

Make sure you immediately  call and lodge a complaint with your doctor about the way you were treated.

new to pace

Thanks for your comment, New

by Persephone - 2021-10-14 17:39:39

I appreciate your response.  I know there is a lot of variability in BP readings based on time of day, time of medication, etc, and that the concept of "white coat" syndrome - or maybe in my case "covid white coat" syndrome - is questioned.  Both of the docs I've seen at this cardiology practice take this same approach to measuring BP - hop up on the exam table and we'll take that measurement now.  Again, this is a serious issue and I'm not trying to be dismissive of their concerns, but it was scary to think that I was going to have be transported to the ER due to the BP spike.  I will monitor BP more frequently, but have plenty of recent data showing reasonable readings.  Thanks again.

spikes

by Tracey_E - 2021-10-14 18:43:47

How high was the spike? They generally allow a higher number in the office/hospital than they'd be happy with at home. Last time I was in the ER, my number was a good 25 above normal and I said something when they measured it. The ER doc said nah, for around here that's ok. So if it was higher than that, I can see why they'd be concerned. Having a trend of good numbers doesn't mean you can't have a dangerous spike that warrants a trip to the ER. Better safe than sorry, no one wants a stroke.

Thank you for your comment, Tracey

by Persephone - 2021-10-14 19:00:26

Yes - this was a similar experience in that the doc had the final say in the matter, and instructed the tech that the reading would not warrant an ER trip today, so I was free to go.  I guess I just needed to vent to the members here due to my feeling of loss of control - I was very confident that the rate would come down given some (not overly long) time, but the tech seemed to go into a bit of a panic that was not very helpful in my case.  I understand the liability issues and I know they're not my caretakers, but it was unpleasant.  Thanks all for letting me vent :)

Spikes in blood pressure

by Gemita - 2021-10-14 20:21:51

Hello Persephone, what a strange experience you have had to go through and what an unprofessional way they seemed to handle the situation.    Taking a blood pressure reading with feet dangling and being unsupported is hardly going to help produce an accurate reading.  Mine would probably have spiked from witnessing the sudden need for a blood pressure check following an echocardiogram unless they saw something on your echocardiogram which required this?

Do you by chance suffer from arrhythmias?  They can certainly push up blood pressure to levels often seen in a hypertensive crisis and if this happened I would not have been surprised that the technician reacted in the way he did.  

What I would do is to take your blood pressure perhaps morning, lunchtime and in the evening for one week and record these figures.  Then present these readings to your doctors, particular if you see any high readings.  They may want to monitor you for 24 hours or to get you to wear an event monitor if they are unhappy with your readings.  My blood pressure is generally very low but in the presence of an arrhythmia, it can suddenly spike to 190/130 or higher which is serious stuff.  Arrhythmias can really mess with both heart rate and blood pressure which is why they can so easily cause a stroke.  Before taking a beta blocker/anticoagulant I could so easily have had a stroke.  There were plenty warning signs and I may even have had a silent transient ischaemic attack somewhere along the way, so please stay safe.

Thank you, Gemita

by Persephone - 2021-10-14 22:41:45

I am very appreciative of your advice, Gemita - yes, I do not get the "let's take BP right now regardless of how you are seated" approach in a cardiology practice.  I understand it at my dentist's office but at least I'm reclined in the dentist's chair when they take my BP.  I understand that these measurements are important, and will increase my measurement-taking and record-keeping so I have proper documentation to share with the doc (who is new to me, only seen once) in my upcoming appt.  No arrthymias have been diagnosed.  I have asked my new doc to continue a beta blocker that I had previously been prescribed for anxiety and will discuss this with him further at my appt.  Thanks again.

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