Squeezing Chest Pain and Angina Pectoris

Dear Ask The Doctor: I am 39yr old female. I am obese, type 2 diabetic usual A1C is 5.5, history of migraines, sleep apnea, and have a permanent impairment due to an accident 6 years ago: C-5 and 6 facet injury, bulging disc, and left shoulder sinovitis. I had a hysterectomy 2 years ago and am on estrogen. Despite all this I have had consistently good level blood pressure. I tend to sit at 115 over 60. I noticed in the last few weeks I will get suddenly irritated at something, usually something mildly irksome but not bad, and my blood pressure will rapidly rise. I feel the pressure rising, my chest hurts like it is being squeezed, and I end up with a horrible headache. Today it happened, and I checked my blood pressure right after, it was 165 over 85. My headache would be a 5 on the 1-10 scale. I do not usually have high blood pressure. After 30 minutes or so my blood pressure returns to normal. It takes several hours for the pain levels to drop back to normal. Is this something to be concerned about? Is there anything that can be done to control the rapid rise in blood pressure?

Dear Sue: Squeezing pain in the chest, as described, is usually associated with a heart condition called stable angina. Stable angina is a type of chest discomfort that occurs because of poor blood flow through the blood vessels of the heart (coronary blood vessels), and this may be caused by narrowing of the coronary vessels from atherosclerosis or a blood clot. The demand in oxygen supply to the heart increases as compared to the supply from the reduced blood flow, causing the few minutes of attack and then getting back to normal.

This condition is more common in patients with diabetes, positive family hisstory of hypertension or heart disease, high cholesterol and obesity which corresponds to your medical history. Anginal attacks occur in conditions of emotional stress, exercise, anemia and may occur anytime during the day. This condition can be treated with medictaions, but if left unattended it can lead to life threatening complications like heart attack. It is in your best interest to contact your family doctor who may refer you to a cardiologist for assessment of the condition. Coronary angiography may be done to confirm the diagnosis and treatment started based on these findings.