Posted by: sunnil kumar
MY FATHER IS AGED 90 YEARS OLD.HE HAD A PROBLEM THAT HIS PRESSURE READING IS 180/100 FOR LEFT HAND AND 120/80 OR RIGHT HAND.HE IS VERY WEAK NOW .CANT GETUP.HIS RIGHT LEG IS VERY WEAK. WHY THE PRESSURE DIFFERENCE SEEN AND WHAT IS THE TREATMENT?
An acceptable inter-arm systolic blood pressure difference is 10mmHg.
If the blood pressure difference is high (he may need to confirm this with a doppler), an underlying condition should be sought. Congenital conditions in the differential diagnosis include aortic coarctation and thinning of 1 of the subclavian, axillary, or brachial arteries. Acquired arterial conditions include aortic dissection, atheroma, thrombus, embolus, and extrinsic compression (as might be seen in association with a mass in the upper chest).
In this case you should have a contrast-enhanced CT of the chest to effectively delineate among the possibilities mentioned above. A vascular ultrasound would be helpful as well, but the CT would better show an extrinsic compression.
Dr. Manish Bhatia