Different Blood Pressure in Arms

[Jayhawkk]

I have had different blood pressure results in each arm for the past few visits now. At two different doctors. They don't seem too concerned although they did say that it isn't normal.


120/80 Left arm on average

145/88 Right arm on average


Ayone else have this? I have no heart murmers or birth defects and haven't been diagnosed with anything. The only other issues i've had are cold calves to feet. Other than that, nothing out of the ordinary.

 

[Mulletsoldier]

How much bigger is your right arm than left arm?

 

[Jayhawkk]

Right arm is 1/4 inch smaller than my left.

 

[SwollOnIron]

Seen this a few time in the cath lab - most common cause is subclavian artery stenosis. Basically, atherosclerotic plaque building up on the lumen of your artery, causing the lumen to narrow and the blood flow (and hence blood pressure) to be affected. Same thing that causes a heart attack, but not in your coronary arteries Not trying to scare you, but how old are you (older people have more PVD)? Ever have your arm or shoulder broken/dislocated (scar tissue can occasionally compress and artery)? Ever been screened for Peripheral vascular disease (how likely your are to dev atheroscleosis in your peripheral arteries)? have diabetes (diabetics have significantly higher incidence of PVD)?

 

[doom3q]

AFAIK You are only supposed to measure it on your left arm because of the artery in it.

 

[Jayhawkk]

31 and no to all the other questions.

 

[SwollOnIron]

31 and no to all the other questions.

You are pretty young for PVD (not impossible, just improbable). Cold calves - think I know what you mean - claudication is always a possibility (another way of saying PVD). Can u always feel the pulses in your feet (ant tibial and dosalis pedis)? DO you routinely lose feeling in your feet?

The BP dif (based on your answers) is Most likely just structural asymetry and not pathological. If you are really concerned, read up on subclavian stenosis or PVD and talk to your doc - tell him you want to have a test (probobly and doppler initially) to rule out claudication. He will most likely tell you it is no big deal and to not worry about it - you have none of the risk factors associated with PVD - I was just being overly disease focused in my initial reply.

 

[Jayhawkk]

It's a almost constant cold burning sensation in my feet that moves to my calves. It really gets bad while sleeping/laying down and all but disappears when moving around. Other than that nothing and my bloodwork hasn't caused the docs to be concerned as i've went to them in regards to my feet problem. They think it has something to do with hyperthyroidism.

 

[BUCKNUTS]

It could also be coarctation which is a narrowing of the left aorta. It causes higher pressures in the right arm, and also can cause decreased blood pressures in the legs and feet which might explain your problem with coldness etc, in your lower extremities a simple doppler study would tell you if this is the problem.

 

[Jayhawkk]

Danke, i'll ask my doc. I have a follow up in a week.

 

[Beau]

I don't think this applies in your case, but I know that the height of your arm (i.e, above or below heart) when having BP measured can impact BP values, as can crossing your feet, legs, etc.

 

[B5150]

I have a follow up in a week.

If it was me, I'd have her check your prostate...just to be safe. :FUfinger:

 

[Beau]

If it was me, I'd have her check your prostate...just to be safe. :FUfinger:

I assume you mean using/with the blood pressure cuff?

 

[SwollOnIron]

Coarctation usually occurs after the subclavian branches, so it would not affect your BP readings in your arms. Additionally you would have extremely elevated BP before the narrowing (ie bot your arms - which is not the case. A diff of 20mmHg systolic is not severe).

 

[BUCKNUTS]

Coarctation usually occurs after the subclavian branches, so it would not affect your BP readings in your arms. Additionally you would have extremely elevated BP before the narrowing (ie bot your arms - which is not the case. A diff of 20mmHg systolic is not severe).

it's a narrowing between the upper body artery branches and lower body branches and it most definitely causes increased b/p in the arms and lowered b/p in the legs.any deviation of more than 10mmhg is considered an abnormal finding is 20mmhg severe? no, but it's not normal either.

 

[SwollOnIron]

Yes it will cause increased BP in the upper extremities (subclavian, brachial, carotid etc), but it cannot be responsible for the difference in BP between his arms. Typical coarctation occures after all upper extremity vessels branch off the aorta.

IF he were to have an anomalous origin of his left subclavian below the narrowing of the aorta this would infer additional congenital pathology of the pharyngeal arches - which is highly improbable if he is otherwise healthy -but only then could the coarctation be responsible for the decreased BP in his left arm.

Here is a link to textbook coarctation with a good diagram:
HeartPoint: Coarctation of the Aorta

 

[BUCKNUTS]

Yes it will cause increased BP in the upper extremities (subclavian, brachial, carotid etc), but it cannot be responsible for the difference in BP between his arms. Typical coarctation occures after all upper extremity vessels branch off the aorta.

IF he were to have an anomalous origin of his left subclavian below the narrowing of the aorta this would infer additional congenital pathology of the pharyngeal arches - which is highly improbable if he is otherwise healthy -but only then could the coarctation be responsible for the decreased BP in his left arm.

Here is a link to textbook coarctation with a good diagram:
HeartPoint: Coarctation of the Aorta

not to be rude or anything(you sound like you have knowledge of the subject) but did you read the link you posted?second paragraph states clearly "the key finding is elevated blood pressure in the arms,with low blood pressure in the legs" which is exactly what I said.At any rate Jayhawk you'll see your Dr. in a week for follow up and good luck with the issue.

 

[Jayhawkk]

Jesus, you guys lost me on page one

 

[SwollOnIron]

not to be rude or anything(you sound like you have knowledge of the subject) but did you read the link you posted?second paragraph states clearly "the key finding is elevated blood pressure in the arms,with low blood pressure in the legs" which is exactly what I said.At any rate Jayhawk you'll see your Dr. in a week for follow up and good luck with the issue.

Yes, I know very well that you said it is caused by high BP in the arms. His question was though - why does he have different BP in his right and left arms. Coarctation usually will not cause asymetrical BP elevation - esp not right bp> left Bp, because the stenotic narrowing of a coarctation would cause a reflux into the left subclavian that if ANYTHING, would lead to greater BP in left arm over right (which is not the case).

 

[BUCKNUTS]

Yes, I know very well that you said it is caused by high BP in the arms. His question was though - why does he have different BP in his right and left arms. Coarctation usually will not cause asymetrical BP elevation - esp not right bp> left Bp, because the stenotic narrowing of a coarctation would cause a reflux into the left subclavian that if ANYTHING, would lead to greater BP in left arm over right (which is not the case).

I didn't say it was caused by the higher bp in the arms I said that's a symptom.I doubt it is coarctation anyways but the symptoms higher bp in one arm signs/symptoms of lower bp in the legs etc. brought that to my mind. variances in bp from arm to arm usually has a mechanical cause ie:stenosis in the vessels proir to the branches of the arm,and if it were me I would want tests done to rule this out.just my 2 cents