Abnormal EKG and High Blood Pressure Before TT? (photo)

Hi, my tummy tuck is coming up on the 25 of Feb. Im so excited and nervous about it that my blood pressure went up at the dr office when i went in for my surgery clearence and my EKG was abormal. I use to take Phentermine and i wonder if this will keep me from having my tummy tuck.Im still waiting for a cardiologist to evaluate me.sometimes i dont know what to do about my blood pressure it only goes up when i am in the dr office.

Doctor Answers 12

White coat hypertension is common.

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Elevated blood pressures that occur only at the doctors office are termed "white coat hypertension." That being said, an abnormal ECG is typically considered part of the equation. Given your photo, so seem to be overweight. A combination of hypertension and an abnormal ECG requires a thorough examination and workup by a cardiologist prior to any surgery.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Abnormal ekg

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Let me be blunt.

How do you know your bp only goes up in the doctor's office?  That is only place you check it.  My guess is that it is up way more than you would ever know- it is the silent killer you know.  I say this with personal knowledge, as I too am on blood pressure meds.

You obviously have a few extra pounds on  you.  My suggestion is that you really listen to the cardiologist. You may want to ask for a stress test to be sure that you not only survive the surgery, but that you do so and do not suffer a heart attack.

A tt is a very vigorous operation and recovery to go through and you need to be in great shape, and have a lot of reserve.  Do not let the excitement of the day prevent you from making good decisions regarding your health care.  It is better to put off the elective surgery if needed so that you can be safe.  Trust me on that, you don't want to be sorry.


Abnormal EKG and high blood pressure before TT?

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Hello! Thank you for your question! There are a few medical comorbidities that contribute to a higher risk during any surgical procedure including infections, wound complications, delayed wound healing, bleeding, anesthetic risks, etc. Hypertension is one that is known to have an increased risk during a procedure. There are a number of both systemic and local host factors that can contribute to high blood pressure. Hypertension itself is not a true contraindication to having any surgical procedure, but it should always be controlled. Risks that coincide with high blood pressure, such as coronary artery disease, pulmonary issues, varicosities, etc. can certainly be worrisome as the risk for other issues including MI, stroke, etc. can be severe. Complications such as bleeding and postoperative hematomas may be increased and hemostasis obtained well.

That being said, well-controlled high blood pressure should equate a minimal increased risk for the above and surgical procedures still safe and a reasonable decision. You should ensure adequate blood pressure control always, but also obtain medical clearance from your primary care physician that you are at an acceptable risk for undergoing a surgical procedure. For elective or aesthetic procedures, your surgeon may want to get you to a baseline level prior to consideration for a procedure. Discuss all of your medical comorbidities and medication with your surgeon prior and discuss these risks. Also, discuss this with your anesthesiologist as proper monitoring and medications will be watched closely. This procedure should still be very safe for you and hope for an uncomplicated course with an excellent result! Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

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This is elective surgery and you need to be fully evaluated and cleared prior to having the procedure performed

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

High blood pressure and abnormal EKG

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Your surgeon is doing the right thing having you see a cardiologist prior to surgery. You question does not specify how high your blood pressure is and what your EKG showed, but the cardiologist should be able to sort it out and make sure you have a safe operation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Abnormal test before surgery

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Thank you for your question. It is not likely that your EKG was abnormal from ‘just excitement & nervousness”. Occasionally, your blood pressure can be SLIGHTLY elevated due to stressors (like excitement), but this would not be the cause for an abnormal EKG. Our patients are required to get blood work (CBC & CMP) prior to elective procedures to ensure they are healthy enough to undergo a procedure. This is done to ensure the safety of our patients. Our patients are also required to stop all medications & supplements (other than those medically necessary). In your situation, the best thing to do now is to see a cardiologist for a full evaluation to ensure you can safely undergo this procedure.


Please note that this response or any answer provided here does not constitute medical advice, patient-doctor relationship, or a replacement for a local visit with a licensed medical professional. All feedback is for information and entertainment purposes only.

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 168 reviews

Abnormal tests before surgery

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Stop the phentermine.  I don't allow my surgery patients to take active wt loss drugs.  Make sure you get surgical clearance from your pcp and probably cardiologist.  A tt is elective and you want to only have surgery under the best possible circumstances.  Good luck!  Dr K

Abnormal results means further workup

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Unfortunately, if you were my patient you would have a full work up including a stress test prior to the surgery.  You don't give us any family history, or past medical history so it is difficult to say.  Have the work up and then have the surgery.  That's the safest way to go about this.

Abnormal EKG and HTN with History of Phentermine and Tummy Tuck

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    The high blood pressure may be episodic and due to nervousness, but you can determine if there is any validity to this by taking your blood pressure at home or at the drug store.  The cardiologist will give you the proper evaluation and make a decision about your high blood pressure as well.  Kenneth Hughes, MD Los Angeles, CA

Abnormal EKG and High Blood Pressure Before TT?

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If your primary wants a cardiologist to see you, that is what you will have to do. It would be helpful to know how high is the pressure and what the EKG abnormality is, but even with all that this issue will not be resolved over the internet.

Keep your surgeon informed of the ongoing evaluation. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.