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Forum Name: Valvular Heart Diseases

Question: White coat hypertension


 gemini1978 - Sat Mar 19, 2005 3:04 pm

I was diagnosed with MVP when I was 9 years old. For the most part, I have not had any "symptons". I am now 26 and have been experiencing "panic attacks" for the past few years. I went to the Dentist to discuss having my wisdom teeth removed and he refered my to an oral surgeon. Well, i was a little nervous because I didn't know if they were going to pull my teeth that day or not. Well, when the nurse took my blood pressure, she had a strange look on her face. She said that she thought that it was an incorrect reading. She took it again and told me that she wanted to use another machine because there was no way someone as young as me could have high blood pressure. It was 165/95. Well, now I was really scared! When they took it the last time, the room was filled with nurses, and as the results came up, everyone had a long face, including my husband. They asked him not to tell me what the reading was and that I need to see a Doctor right away. The Oral Surgeon wrote the reading on a piece of paper and sealed it in a n envelope and instructed me to give this to the Doctor that I see. Okay by now I am so scared and my poor husband was trying to keep me calm. I just had to know the reading, so he gave in and told me that it was 175/103. To make a long story short, I went to the Doctor, he gave me some blood test. The results were back with in a few days. He said that everything came back normal except my blood count was 199 which meant I was Diabetic. He conducted more blood test to see what my blood count average was over the past 3 month. The results came back to show that I did not have Diabetes! Durring the wait time, he asked that I buy a blood pressure machine and to report back to him what it was. Well, It was very normal when I took it at home 118/72. So his opinion was that I have " White coat Syndrome".

After all of that, I find myself worried all of the time about my blood pressure, heart rate etc. My heart races a lot, and I sometimes have palpetations. I know that I should go to see a Cardioligist, but I am scared. I know that when I go, I will be nervous and maybe give an inaccurate reading, or that they might dismiss it as just "white coat syndrome" and there really could be a problem. Please give me your advise
 Dr. Yasser Mokhtar - Sun Mar 20, 2005 4:28 pm

User avatar Dear Gemini1978,

There is a well known entity of patients who develop hypertension only when they are at the doctor's office and this is called white coat hypertension.

Stress and worry elevates heart rate and blood pressure because of activation of the sympathetic nervous system which causes increase in the adrenaline in the body leading to the feeling of apprehension, having increased blood pressure, heart rate and blood sugar among many other actions.

When you have high blood pressure at the doctor's office and normal blood pressure readings at your house (and assuming that both your blood pressure machine and the one at the doctors's office are correct), this is a case of white coat hypertension and when someone tells you so, he/she is not dismissing you as just a case of white coat hypertension because this is a true entity.

Having a random blood sugar reading of 199 is not diagnostic of diabetes and a three months average blood sugar test is not used either to diagnose or rule out diabetes. A fasting blood sugar is the test used.

The palpitations and the racing of the heart that you have is most probably related to your mitral valve prolpase if not due to stress. If they are really bothering you, you can see either your primary care physician or a cardiologist and there are medications that can be given to treat these palpitations.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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