I'm really worried about my health lately. I've been dealing with diabetes and high blood pressure for a year now. Last October, I went through some tests like an echo, and everything seemed normal except for some grade 1 diastolic dysfunction. The TMT was negative, and my ECG looked okay. But I'm still having chest pain and pain in my left hand every week, and my heart sometimes races to 150160 bpm, with blood pressure at 180110. I even feel like passing out once a month. I've got pain in my chest, left hand, and jaw too. The doctor said last year that it wasn't a cardiac issue, but I can't shake off these symptoms. Without my blood pressure meds, my blood pressure spikes to 170110 and my heartbeat to 130. I'm currently on metoprolol, talmisartan, and vildapride. Its been seven months since those tests; should I go for another echo or TMT? Ive attached my last years reports and recent ECG too. What do you think?

Based on your history and symptoms, it would be advisable to undergo a repeat echocardiogram and stress test (TMT) to assess your heart function and rule out any cardiac issues. Considering your persistent symptoms and the changes in your blood pressure and heart rate, it is crucial to ensure that your current medications are effectively controlling your conditions. In addition to your current medications (metoprolol 50mg twice a day, telmisartan 40mg twice a day, and vildagliptin-metformin 50500mg twice a day), your healthcare provider may need to adjust the dosages or consider adding other medications to better manage your blood pressure and heart rate. Please follow up with your healthcare provider for a thorough evaluation, including a repeat echocardiogram and stress test, to determine the underlying cause of your symptoms and to optimize your treatment plan. Regular monitoring and follow-up are essential in managing your diabetes, hypertension, and cardiac symptoms.