Post AVR blood pressure

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dennie

Active member
Joined
Dec 2, 2004
Messages
31
Location
New York
Hi, guys, I have problems/questions again. I am now about 4 weeks post AVR. The healing process seems to be OK, although not perfect. The unbearable pains on the lower ribs have gone. I can lie flat to sleep during the night. I can actually turn to both sides without feeling much pain. But my blood pressure seems to be quite off. I got the readings 140-150/90 both today and last week when I visited the doctors. My systolic one was fluctuating and always on the high side before the surgery which I guess was mainly due to my bad valve. But my diastolic one was always fine at around 60. The doctor did not want to do anything to it yet. I am wondering if this is what normally happens after AVR? BTW, I am feeling soreness on both sides of my chest and both inside and outside the ribs. Is this also normal?
 
It certainly is normal. You'll have fluctuation for some time to come yet. Things should settle into a more normal pace soon. The pains will be there for a while yet too. I was very sore into 8 heck even 12 weeks later.
 
Hi Dennie

My cardio explained me that my blood pressure is higher after the surgery, for a while anyway, because the heart has to get adjusted to effiecent the valve.
I had a lot of hot packs on my chest around my 5 weeks post surgery. That was the only thing which gave me relive. With rest and the hot packs i felt better very soon after.
I am 8 weeks post surgery and sometimes still get the pains back. A quick hot pack still fixes me every time.
hope that might help you too.
Eowyn Rose
 
Hi Dennie,

My blood pressure, even with medication, was high in the hospital after aortic valve replacement and for several months afterward. Readings of 165/95 were typical. Then it settled down.
 
Thanks, guys, for replying. So it will take, say 3 or 4 months before it can be judged as transient or permenant?

I went to see my doc again last Friday, which marks 7 weeks post surgery and 3 weeks from last time I saw him. Well, since he is leaving for another hospital, this time I actually saw another doc. The readings did not change much from last time's. This new doc told me that it was probably permanent and gave me some medication for that. Shall I take the prescription? or I can skip the drug and give it a little more time to adjust itself ? (I am exercising everyday, of course.) I am a little afraid that once I start taking the medication, I will become dependent on it and lose the function of self adjustment. I am wondering how big the damage would be by staying on the higher blood pressure for 3 or 4 months. My aorta is already dilated so may be more vulnerable to high blood pressure. Oh, forgot to mention, something like 140/90 is my typical blood pressure reading, sometimes it may be a little higher, sometimes a little lower.
 
This far out, he's probably right. I would begin the medication. What did he prescribe? High blood pressure is nothing to fool with. You'll probably need the medication for life, but it beats blowing your aorta to shreds or blowing a vessel in your brain or damaging your kidneys! :eek:
 
Seven weeks post-OHS is very soon for anything in the heart's responses to be deemed permanent. Your heart and circulatory system are definitely still in adjustment. Taking medication now could potentially affect the way your body adjusts to itself.

Not that it can't be permanent. It just doesn't seem reasonable to be certain about it at this early time. The easiest thing would be to reapproach the advice with this doctor, especially noting your concern, and see if he will flex with you for a few months.

And if not... No one can or would counsel you to go against a doctor's prescription, but you could certainly run out and find another doctor who prescribes differently, and who doesn't rush you into medication.

Best wishes,
 
Forgot to mention, I was prescribed Cozaar 25mg. One more question here, my blood pressure before the surgery was something like 135/60. The high systolic one, as I understood it, was due to the fact that the heart was pumpting harder due to the aortic valve regurgitation. While the diastolic one was low due to the fact that blood coming back to heart also due to the regurgitation. So, I would expect they both move towards the middle post surgery. Am I right on this?
 
If my BP was 140/90 I would definately go on the BP medication. I had my AV replaced and an Aortic aneurysm repaired. My Surgeon wanted my systolic BP kept in the 90's post op. Since you already have a dilated aorta, why put pressure on it? Anybody with BP above 120 systolic is considered pre hypertension. My BP has always ran low, and I was put on Lopressor post op, it was decreased at the 4 week mark and then again at the 6 week mark. If your BP comes down, they can taper you off the medication.
Kathy H
 
dennie said:
Forgot to mention, I was prescribed Cozaar 25mg. One more question here, my blood pressure before the surgery was something like 135/60. The high systolic one, as I understood it, was due to the fact that the heart was pumpting harder due to the aortic valve regurgitation. While the diastolic one was low due to the fact that blood coming back to heart also due to the regurgitation. So, I would expect they both move towards the middle post surgery. Am I right on this?
Blood pressure is a funky thing. So many things are involved that it's impossible to say what causes it or what changes it. You can spend your life searching for that answer and never find it.

Relax and take your Cozaar. Talk with the Doc about it, but honestly by now, you probably need to be started on something.
 
Seems I'm outvoted, even though I agree with your first doctor (what would make the second doctor more right, by the way?).

I posted an article (from the AHA site?) some months ago about office BP readings, and the fact that they frequently lacked real accuracy to patients' non-office pressure.

If you want to know what your blood pressure really is, get a good BP machine and check it at home, at least twice a day, from these five times, alternating between them as far as is practical. Early morning, mid-morning, noon, early afternoon, evening. Do it for at least a couple of weeks, preferrably a month.

If you want your cardiologist to know what your BP really is, ask to have an ambulatory BP monitor put on your arm for 24 hours.

I don't know how anyone would think that most patients who have recently had OHS would go to a cardiologist's office and present a blood pressure that is normal for them. Most of us are hyper, concerned that they'll find something wrong with their ceaseless prodding.

My cardiologist wanted to put me on BP medications because my office pressures were high (higher than yours, by the way, on both sides of the slash). I persuaded him to put an ambulatory BP monitor on me for 24 hours. Result? BP normal all day and night - except when I went to his office. Conclusion? Cardiologists cause high blood pressure. :D

No further medications offered. How many other people who are already taking medications might not really need blood pressure prescriptions?

There is nothing wrong with being sure before you start ingesting prescription drugs, nor should a doctor object to taking a few days to be sure of his diagnosis. Your BP is not so outrageous as to cause damage in a few days, even if it is not a result of white coat syndrome. If you are moved to act now, it would be reasonable to ask for a 24-hour ambulatory BP monitor for your peace of mind.

Knowledge is power,
 
Thanks for all the suggestions. I actually do the measuring at home, quite frequently. During the daytime, my bp is in general a little lower at something like 130/78. But both in the morning and evening, it is 140/90. So I would say it is consistently high (although I do get a little nervous even when I do the measuring myself alone). I guess I will start the medication and see if I will have the luck to get off it.
 
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