I have a resistant hypertension. Even five drugs failed with a lot of side effects. I was safe on Methyldopa for 2 years with Hydrochlorothiazide. Now, there is no supply of this medicine. I started Nebivolol 5 mg with Chlorthalidone last night. I have the feel of chest tightening and slight giddiness. All my blood pictures are normal, including cardiac markers. What would be the best for me? Telmisartan 80 mg, Metoprolol, Prazosin and Ramipril combination does not seem to work. Blurred and double vision, steatorrhea, giddiness and palpitations were the problems I had and they all went off with Methyldopa. Please suggest any best combinations. Thank you.
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Most likely pheochromocytoma or renal artery stenosis.Investigations to be done:
Complete cardiac checkup, 2D echo, treadmill test, renal artery Doppler, MRI kidney to rule out pheochromocytoma, serum vanillylmandelic acid and serum metanephrines.Treatment plan:
Medications as advised.Regarding follow up:
Revert back with the detailed history and reports to a cardiologist online.---> https://www.icliniq.com/ask-a-doctor-online/cardiologist
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