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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19320
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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35 year old on ramipril tablets as gave high blood pressure/white

Customer Question

35 year old on ramipril tablets as gave high blood pressure/white coat syndrome. Have palpitaions today again nearly 7 times day. My doctor last time said my palpitations where nothing to worry about.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

It is true that most of the time when palpitations occur in a 35 year old female, it is not a serious issue, but I can make a better statement with knowledge of what evaluation was done.

What evaluation was done for the palpitations?
When you say you have white coat syndrome, do you check your blood pressure at home?
If so, what does it typically run at home?
Customer: replied 2 years ago.
I first was diagnosed with blood pressure on my first pregnancy and on tablets all through pregnancy then came off tablets when baby was 6 months old. On second pregnancy blood pressure was high and had to go back on tablets again. Only seem to get these palpitations now and again around middle of menstrual cycle. I had them in doctors surgery one day he listened to heart and said innocent nothing to worry about.
Expert:  Dr. D. Love replied 2 years ago.
Very good. It is somewhat lucky that you had the palpitations in the office. Frequently, when palpitations only happen intermittently, they do not happen in the doctor's office, so it is more difficult to perform an assessment. However, in your case, since the palpitations occurred in the doctor's office, the physical examination can identify causes of palpitations that are not worrisome, most often from PACs, or premature atrial contractions. Obviously, I cannot perform the same examination over the internet, but I can say that when the exam indicates that it is not a worrisome cause of palpitations, that is reliable and you do not need to be concerned about the palpitations.

As for the blood pressure and white coat syndrome, it is true that women that develop high blood pressure during pregnancy are at significantly higher risk to subsequently develop high blood pressure when not pregnant. However, in someone with white coat syndrome, the decision of whether high blood pressure medicines are needed is usually based upon what your blood pressure is running most of the time. So, if your blood pressure is normal at home and is only elevated when at the doctor's office, that usually would not require treatment. In someone that is already taking medicines, the decision of whether it may be able to be stopped also would be dependent upon what the blood pressure is running most of the time at home. If you do not have a blood pressure cuff to monitor your blood pressure at home, then it would be a good idea to acquire one.

If I can provide any clarification, please let me know.