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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 32679
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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I want to know if an 83 year old woman, who has been previously

Resolved Question:

I want to know if an 83 year old woman, who has been previously very well with a history of raised blood pressure on blood pressure medication once a day presents with a history of the following - what would be the treatment.
raised bp - 190/110
raised pulse - 150 b/m
'funny turn' at ten am, waited two hours to see if bp came down and pulse came down before calling GP out.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.
Hi. What blood pressure medication is she on? What did you mean by funny turn?
Customer: replied 2 years ago.

She felt light headed, disorientated and dizzy. I am not sure what medication she is on, but she has been on it for several years, once a day slow release.

My concern is that she needs admission for stroke assessment, not an ecg in a few days time!

Expert:  Dr. Chip replied 2 years ago.
OK Jude. I fully agree with you that she needs to be in the ER. That blood pressure was much too high and it may be that she had a run of something called atrial fibrillation which can cause a stroke. If may just be that the arrhythmia itself caused her symptoms and this wasn't a threatened stroke but still she needs immediate evaluation
Customer: replied 2 years ago.

The reason I am asking is that her GP has asked her to have an ecg and recommended medication to thin the blood ...... I am not happy and think she needs stroke assessment. I am a midwife but no expert in these matters. But I am in the UK where the NHS is on its knees, so GP's are under pressure not to admit patients to hospital.

Expert:  Dr. Chip replied 2 years ago.
I understand Jude. But she needs an immediate ECG to look for the atrial fibrillation and I wouldn't thin her blood until that was confirmed. That said, I agree she also needs an MRI of her brain and a full neurological workup so I still say take her to the ER
Customer: replied 2 years ago.

what do you mean ER, are you in the uk? do you mean emergency room??

Expert:  Dr. Chip replied 2 years ago.
Sorry--yes--emergency room or A&E.
Customer: replied 2 years ago.

Thank you and I am guessing you are not in UK.

Expert:  Dr. Chip replied 2 years ago.
No, I'm in the US but my advice would be exactly the same if I were in the UK. Let me know how she does and please remember to rate my service to you
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Customer: replied 2 years ago.

I will tell you now, 14 hours after being seen by her GP my mother had a huge stroke. I am not happy with her gp prescribing dabigatran prior to doing an ecg. But I wanted to have some idea of the best treatment for her symptoms. I know hind sight is a wonderful thing but her GP left her alone in the house after seeing her.

Thank you for answering my questions.

Expert:  Dr. Chip replied 2 years ago.
Sorry to hear that Jude. Let me know how she does.