DEAR DR. GOTT: I have a right bundle branch block, high blood pressure, diet controlled diabetes, angina pain, shortness of breath, etc. As I age (I’m 63) it becomes more bothersome. Any information would be helpful. Thank you.
DEAR READER: A bundle branch block results from an obstruction along the pathway that sends electrical impulses to the right or left side of the heart, making it increasingly difficult for the heart to pump blood efficiently throughout your circulatory system. A left bundle branch block, the more serious one of the two, is commonly due to a form of heart disease, while a right block is less likely. That’s to your advantage. Some individuals can have a right block without any symptoms at all, while others may show signs of bradycardia (a slowed heart rate), syncope (fainting), or pre-syncope (the feeling that fainting is imminent). The most widely used test to diagnose a block is through an electrocardiogram (EKG).
Should there be an underlying heart condition that caused your right block, treatment is recommended; you cannot improve until you address the base problem. Once that is accomplished, you may find all our problems reduce in intensity more and more every day. You may have to consider medication to lower your blood pressure, pacemaker insertion, or even angioplasty. Your cardiologist is your best resource and can explain his or her recommendations in detail based upon your history.
The form of diabetes you have is known as type 2 – a non-insulin dependent form that affects how your body metabolizes sugar. When your body’s cells are deprived of that sugar, you can become fatigued and irritable. A diabetes diagnosis is easily determined through blood testing that can be accomplished right in your doctor’s office.
Hypertension is a common condition that occurs when the force of blood against the walls of your arteries is higher than it should be. There are two forms of high blood pressure – primary and secondary. Primary occurs over a number of years, while secondary can appear suddenly. Risk factors out of our control include family history, race and age; however, those within our control include leading a sedentary lifestyle, being overweight, consuming too much salt in one’s diet, drinking in excess, stress, and a host of other possibilities.
Angina, simply put, is chest pain caused by a less than optimal amount of blood flowing into the coronary arteries that nourish the heart. Symptoms may include shortness of breath, fatigue, nausea, and pain in the jaw, back, arm, or chest. Stable angina commonly occurs with exertion and dissipates with rest. Unstable angina may last 30 minutes or longer, occurs whether during exercise or at rest, may not disappear even with prescribed medication and could signify a heart attack. Immediate intervention by a specialist if these latter signs occur is critical. Factors that increase your risk for angina include high blood pressure readings, diabetes, high cholesterol levels, stress, lack of exercise and more.
Issues you can address now include lowering your cholesterol levels if appropriate, exercising regularly, maintaining a healthy weight through good dietary choices, and ceasing smoking if you do so. If you are a salt user, remove the shaker from your kitchen table. Reduce your stress level. Perhaps a visit to your local hospital’s dietary department can provide some additional ideas for what to do to bring your blood pressure readings down to a more acceptable level. Obviously no exercise program or major dietary modification should be initiated without the endorsement of your cardiologist so run every thought past him or her before beginning such a program.
You need help now. If you aren’t presently seeing a cardiologist, ask your primary care physician for a referral. Bring your medical history with you, along with a list of any medications you might be taking. Determine the underlying cause of your block, take the necessary steps to correct it if possible and get your life back on track. You are too young to have so many problems. You deserve better.
Readers who would like related information can request a copy of my Health Reports “Coronary Artery Disease”, “Hypertension” and “Diabetes” by sending a self-addressed, stamped number 10 envelope and $2 US or money order for each report to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.
