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Hypertension Crisis Saturday Night

Ended up in the ER the other night
BP 190/137
and then various other high ratings
Was taken straight back to the emergency room I had no other symptoms was taken straight back to the emergency room I had no other symptoms
EKG was normal
All cardiac labs (troponin etc) were perfect
TSH good A little on the low end but within range
Medicine through an IV stabilized BP 127/70
even though it kept jumping at various time they had done everything they could without being able to figure out why I had such high numbers
then out of nowhere my heart rate shot up and I was in a full-blown panic attack mostly because I kept looking at the monitor previously and seeing those horrible blood pressure readings thinking I was gonna die right there in then
they gave me 1 mg of Ativan
that call me down and sort of knocked me out for a little while once it wore off I seem to be doing OK they did a chest x-ray which was clear
The ER doctor was getting ready to discharge me with follow up with internal medicine or an endocrinologist just for further testing when suddenly my heart rate shot up to 150 then 160 then back down to 90 and became erratic
She had techs rush me to over to CT with contrast for a scan to check my lungs for possible blood clot but that was clear except for the fact they found a small cyst on my spleen which had probably been there for a long time however they found my thyroid was diffused
finally everything settle back down and I was discharged after being given another IV of fluids and so forth and still follow up with an endocrinologist unfortunately it will take four months to get that appointment as well as a long wait for Internal Medicine
I have multiple sclerosis in addition to this which I have had for 10 years
I really didn’t want any medicine because I try to take as little as possible but she didn’t think I needed to be on blood pressure medicine or anything like that I question is does anyone have a clue what would cause this and could it really be that thyroid and with a simple thing like Synthroid maybe help with that
I need to have an ultrasound on my thyroid as well but in the meantime I’m doing all I can eating a very very low salt diet doing the best I can with exercise daily given I have MS but I’m just very concerned if anyone has any thoughts I would be so grateful
1 Responses
15695260 tn?1549593113
Hello and welcome to the forum.  That sounds like a really frightening experience and we're sorry you went through that.  If you have anxiety, this can be a bit difficult for that condition, but typically, regular monitoring of blood pressure is recommended under these circumstances.  Do you have a home monitor?  And with this situation, I would think they'd suggest a cardiologist to make sure all is well.  This article gives some pretty basic and easy to understand information regarding sudden and erratic spikes and falls of blood pressure. https://www.healthline.com/health/fluctuating-blood-pressure  Things like an overactive adrenal system could be involved and yes, you'd work on that with an endocrinologist.  Stress and anxiety itself can actually cause these spikes.  This is something for you to work on with a psychiatrist.  But overall, the first thing to do is rule out a cardiovascular issue.  An emergency room is great for acute situations but not for chronic problems.  Monitoring your bp is important.  Although I realize this may give you more stress initially.  Monitor it about three times a day at different times.  Calmly sit with feet flat on the floor and arm /blood cuff at heart level, think peaceful thoughts, stare at a picture of the beach or something calming to you.  If you rule out actual cardiovascular reasons for the bp surge, then it's time to look at secondary hypertension causes.  https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679  

Please note that all of the things that help with hypertension should still be instituted.  These include losing weight if you need to, eating a heart healthy diet, limiting sodium, regular physical exercise and proper sleep.  
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