Can white coat hypertension affect an EKG?

S

smig

Well-Known Member
I have had white coat hypertension since I was a youngster. I have monitored my blood pressure and pulse at home for years and typically get 110/60 with a pulse of around 75-80.

When ever I have to get my medical I get nervous (I get nervous for any type of doctor or dentist appt). I can actually feel my heart pounding in the waiting room and I know that my blood pressure and pulse are going to be elevated. Today my bp was 137/78 with a pulse of 130! They checked my pulse a few more times during the exam and finally I had it down to a point where they were happy. I am not sure what my pulse was when they were satisfied, but I know it was still higher than my normal 75-80 at home.

My concern is this... I will be turning 35 in a couple years and will need an EKG. Is it likely that my nervous fast pulse and elevated blood pressure in the doctors office is going to interfere with the EKG? What if I can't relax enough in the doctors office when it come time for an EKG?
 
I had the same problem and the ame asked me to get 24 hr blood pressure monitor from my family doctor so i did and evevrything was fine. He recorded the results and gave me a note to give to my ame indicating my b/p is normal and diagnosed with wcs, The ame kept one copy for himself and send one to the feds and told me not to worry anymore since it won't matter what my b/p's reading will be for next time and that took the whole world off my shoulders. I hope this helps but i'm sure doctor forred may have another solution:rawk:
 
I remember my first aeromedical exam (2 months ago) and I had a heart rate of 160 systolic! After sitting alone with my eyes closed for a while i got it down to 135 systolic but i know its better than that. I got in the 120s last time at my regular doctor checkup before that. I would really like some advice on how to combat this, I get very very nervous during doctor appointments, especially an FAA medical exam.
 
Kestrel452 said:
I remember my first aeromedical exam (2 months ago) and I had a heart rate of 160 systolic! After sitting alone with my eyes closed for a while i got it down to 135 systolic but i know its better than that. I got in the 120s last time at my regular doctor checkup before that. I would really like some advice on how to combat this, I get very very nervous during doctor appointments, especially an FAA medical exam.
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We talking blood pressure, I'm guessing. Even a heart RATE of 120 is a little high. :)
 
Kestrel452 said:
I would really like some advice on how to combat this, I get very very nervous during doctor appointments, especially an FAA medical exam.
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You and me both! I am not sure there is a way to combat it. As soon as I got home from my medical I took my pulse and it was 74. It is amazing how fast I can calm down once they sign that slip of paper saying I am good for another year.
 
My Flight Surgeon said:
I have never had white coat hypertension affect an ECG significantly.
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I don't know if you would call it "white coat hypertension" or not, but I've had a few pretty nurses raise my heart rate a bit when they were attaching the ecg leads to my chest.;)

smig said:
Does a high pulse prevent an EKG from being done? I heard somewhere that the pulse has to be below 100 for an EKG, not sure if its true or not.
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By definition, I believe that 100 bpm or more is tachycardia. Whether or not that is an automatic deferral without any other arrhythmia, I don't know.
If this is a common problem for you, maybe you should see your primary physician. I have heard of some doctors treating wch with non selective beta-blockers. And I think beta-blockers are approved for treating hypertension.
 
Old Pete said:
By definition, I believe that 100 bpm or more is tachycardia. Whether or not that is an automatic deferral without any other arrhythmia, I don't know.
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My pulse gets that high ONLY at the doctors office. I have been monitoring my BP and pulse at home for many years and never have elevated numbers when at home. Even when I am feeling stressed out at home, my numbers don't significantly increase from my norm of 110/60 and 75-80 bpm.

ETA: I just did a check a minute ago: BP = 112/70 Pulse = 72
 
smig said:
Does a high pulse prevent an EKG from being done? I heard somewhere that the pulse has to be below 100 for an EKG, not sure if its true or not.
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No, it does not prevent it. We try to get people to relax but the pulse rate itself does not keeo you from an ECG.
 
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