Posted by: Nicki | 2012/09/28

Low blood pressure and bradycardia and chest pain

Dear Doctor

I am a 51 year old woman, non smoker and moderate drinker, slightly overweight and not very active. I was recently diagnosed with several rickettsial infections and am on antibiotherapy at intervals of 3-4 weeks. The doctor told me that I had a heart murmur but did not expand. My cholesterol is 7.2. I have family history of heart disease (some in their 50''s) on both parent''s sides. I was hospitalised with chest pains and palpitations in 2009, with a slightly abnormal ECG and took crestor for 2 years. I am feeling very ill, have intermittant pain over my sternum and a feeling of fluttering in my throat - almost as though the blood flow is not sufficient. I feel panicky and fatigued. My blood pressure seems low. The last reading was 98/54 with a pulse of 64. I would like to know whether I need to see a doctor or just take it easy and let the meds do their work.

Thank you.

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Our expert says:
Expert ImageCardiologist

Dear Nikki

It sounds from your description as though at least some of your symptoms are psychological. “Several rickettsial infections” requiring courses of antibiotics does not sound very plausible.
A couple of different questions arise. The first and most important is: why do you have symptoms that you have? I suggest you arrange to see a good general physician.

The second and unrelated question which needs to be answered, because of your family history and high cholesterol, is whether you are at risk for coronary disease. If you are pre-menopausal, don’t smoke and have a low blood pressure, such as you have, then your risk is probably very low, despite your elevated cholesterol. A good general physician should also be able to answer this second question. If doubt remains about your risk, then a coronary calcium score would help considerably. (A simple CT scan of the heart without contrast, which will tell you if you have any hardening of the arteries and also how much).

Best wishes, JT

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