Hypertension at 21, chest pain, forceful heart beat, and now upper back pain as well.

[menator]

In early August of 2006 I was diagnosed with hypertension as my bp was in the range of 160/70. I was started on adalat cc 60mg/daily and later toprol xl was added at 50mg/daily. I was checked by a kidney specialist whom found that my aldosterone was very high ( I think 24 was the number ). I was then put on Inspra at 50mg/daily. At the end of December 2006 I started getting fleeting sharp chest pains in the center of my chest. I again went to the doctor who put me on reflux medication. It seemed to help somewhat, but the pains kept on coming back. I saw my doctor again in a few months and put me on Xanax .5mg as needed. My kidney specialist told me to visit a cardiologist. This brings us to late 2007. After two echos, two stress tests, and two holters everything came back fine but he wanted me to see another cardiologist just in case. The new cardiologist ordered an echo of my heart and carotids. They thought that I might have a bicuspid aortic valve and coarctation of the aorta. I was sent to get a ct of my aorta which came back fine. They also found that I had 50% and 40% blockages in my carotids. A repeat echo of the carotids showed 20% and 10% respectively.

All of this and I am still having chest pains. I am now experiencing pain in my neck(along the left front side and color bone area), lower arms, and upper back. All of it is fleeting lasting less than 2 mins. with the exception of the upper back pain( between my shoulder blades and higher ) which seems to linger. Sometimes the upper back pain feels sharp, other times it feels achy. I've done the web-o-chondriac thing and looked up all sorts of possibilities( valvular problems, aortic dissection, spinal compression, muscular tension, etc. ) which I think has only made me more stressed. I guess the good thing is that they've ruled many things out, but I also know new things can develop. My bp has been pretty good over the last year (avg. 125/70), but has been creeping up lately( over 140 ). What should I do?

[Lee Kirksey, MD]

Hello
Lots of information. Most of your studies, and you have had a lot, appear normal except for your BP. You have been tested extensively for cardiac disease including echos and a stress test. Im not sure if one of your echos was a stress echo. I might recommend that

Short of that, you mentioned nothing about  the condition of your 21 year old body including your height, weight, cholesterol level, level of activity. All potentially important factors in premature hypertension.

Additional causes of non-essential or correctable hypertension include renal artery stenosis, diagnosed by ultrasound, CTA or angiography. Other causes of non essential or secondary hypertension include:

Cushings syndrome
Aldosteronism
Pheochromocytoma
Hyperthyroidism
Aortic coarctation
Sleep Apnea

[menator]

I'm 23 now, diagnosed with hypertension when I was 21. 6 feet 1 inches tall about 190lbs. My cholesterol levels have been good with slightly elevated triglycerides. I don't exercise very much, but do walk about 2 miles a day after work.

I've been screened for renal artery stenosis, pheochromocytomas, thyroid issues, and the aortic coarctation. I was diagnosed with primary aldosteronism and am taking Inspra 50mg/daily for that.

My concern isn't really my blood pressure as much as it is the pain that I've been experiencing for quite some time. It seems to be getting progressively worse.

[cathy63]

I also had an echo and stress tests, which were normal. I continued to have chest pain, pain in right arm when walking, pain in between shoulder blades. My cardiologist told me these tests were not always reliable and the only way to know for sure if I had a heart problem was to do a angioplasty. This test showed I had blockages and I had a 4 by pass heart operation 4 years ago. My cardiologist was unable to put in a stent because the blockages were in an area where it was to risky a procedure. I would have the angioplasty done. Good luck
  

[Melvine]

I'm sorry to hear about your problem. I am 26 and i'm feeling as if the whole world is on me. Palpitation , chest tightness , breathing difficulty , chest pain - i got them all.

My blood pressure was crazy. All along it was 120/80 and it went to 140/90 to 160/90 and back to 120-130/80. Now it is 140/90. There was nothing wrong with thyroid. I have heard of adrenal stress test. Perhaps you want to test your thyroid.

I have 2 echo (but not thallium stress which my 2 cardiologist insist i do not need) which reveal mild trival valve prolapse. I realized it is a potential cause for chest pain. I hope MVP explains ur problem cause it is the least of the worries.

I don't understand. My cholestrol is good (like u) and my weight