I had high BP and a low heart rate. Is my ECG showing infarction?

Q. High BP and low heart rate. Is my ECG showing infarction?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Aug 20, 2018 and last reviewed on: Jun 03, 2024

Hi doctor,

I had high blood pressure, low heart rate. Is my ECG showing infarction? I have no chest pain. At the time of ECG, my blood pressure was 168/100 mmHg and heart beat 46 beats per minute.

#

Hello,

Welcome to icliniq.com.

I have gone through your ECG (attachment removed to protect patient identity). The reports mentioned on ECG are machine generated and are frequently inaccurate. There is no clear-cut evidence of myocardial infarction on ECG. As you also do not have any history of chest pain, it is unlikely for you to have any heart attack. And yes, heart rate is low and it is sinus bradycardia. Do you have any symptoms of dizziness, syncope, etc? If not then it needs no action at the moment. However, you should undergo thyroid test to rule out hypothyroidism as a cause for low heart rate. Also, should undergo echo, which will additionally provide the assurance to rule out MI. Also, if echo is normal then should have TMT (treadmill test), which will help in ruling out minor blockages, subclinical ischemic heart disease and to look for maximum heart rate you achieve during exercise, which will help in determining the benign nature of sinus bradycardia if the adequate heart rate is achieved. Also, high bp can also cause low heart rate by a reflex mechanism. So you should have medicine for it. I guess you are not receiving any medicines like beta blockers which can reduce heart rate. You should have tablet Telma CTD (Telmisartan and Chlorthalidone) 40/12.5 mg once a day in the morning for hypertension so get it prescribed by a local doctor.

Thank you doctor,

Any other good substitutes for Telma? I have no insurance.

#

Hi,

Welcome back to icliniq.com.

Alternatively, you may have tablet Amlodipine 5 mg once a day in the morning, and may be increased later if needed, but with doctor's prescription. So should begin with Amlodipine 5 mg.


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