Question 1

I'm 86 and I've been having some issues. I've been getting occasional angina pain and my doctor told me to take Imdur isosorbide mononitrate, 30mg every day. But since I started, I've been feeling dizzy when I stand up or get out of bed, so I'm guessing it's because my blood pressure drops. Should I stop taking Imdur, or is there something else I can do? I'm not sure what's best and would really appreciate some advice.

Accepted Answer

Don't stop Imdur abruptly. Consult your cardiologist  to adjust dosage or switch to alternative medications. Possible solutions:

Medical Adjustments

1. Reduce dosage: Gradually decrease Imdur to 20-10mg daily.
2. Alternative medications: Consider nitrate-free options like beta blockers or calcium channel blockers.
3. Combination therapy: Add medications to stabilize blood pressure (e.g., fludrocortisones).

Lifestyle Changes

1. Increase fluid intake.
2. Elevate head while standing.
3. Slow rising from bed.
4. Avoid sudden movements.

Monitoring

1. Regular blood pressure checks.
2. Electrocardiogram (ECG) monitoring.
3. Follow-up appointments.

Question 2

I'm a bit worried after reading my 2D echo report. It mentions mild tricuspid regurgitation and mild pulmonary hypertension with PASP by TR jet measuring 38 mmHg. Does this mean I definitely have pulmonary hypertension? And should I be concerned abou...

Accepted Answer

Mild pulmonary hypertension is indicated by a PASP (Pulmonary Artery Systolic Pressure) of 36-50 mmHg. This means that there is increased pressure in the pulmonary arteries. To manage mild pulmonary hypertension, your doctor may recommend lifestyle changes and medications such as sildenafil (Revatio) or tadalafil (Adcirca) to help lower the pressure in the pulmonary arteries and improve blood flow. It is possible for pulmonary hypertension to progress to moderate or severe levels in the future, but with proper management and regular follow-ups with your healthcare provider, the progression can be slowed down or even prevented. Regular monitoring and adherence to treatment plans are crucial in managing pulmonary hypertension.

Question 3

I'm trying to understand what a zero calcium score really means for my heart health. My CT scan showed a score of zero, and my doctor mentioned that I'll need another scan in 10 years. He ordered some blood tests for cholesterol and Hs-CRP, which he ...

Accepted Answer

A zero calcium score on a CT scan indicates that there is no evidence of calcium deposits in your coronary arteries. This is a good sign as it suggests a low risk of coronary artery disease and heart attack. The fact that your cholesterol test and Hs-CRP test results were good further supports this. The CT scan can also provide information about the anatomy of your coronary arteries, such as any blockages or narrowing that may be present. Since your doctor has recommended a repeat scan after 10 years, it is important to continue following up with regular check-ups to monitor your heart health.

Question 4

I'm experiencing some issues with my breathing, especially when I go up the stairs. It feels like I'm getting out of breath really quickly. Can you tell me what test I should get to figure out what's going on?

Accepted Answer

The test you may need is called Pulmonary Function Test (PFT). This test can help evaluate how well your lungs are working and identify any breathing problems. In the meantime, you can use a bronchodilator inhaler like Ventolin (albuterol) as needed for relief. The usual dosage is 1-2 puffs every 4-6 hours as needed for shortness of breath.

Question 5

I'm a 27-year-old who's just gone through some heart tests like the ECHO, ECG, and Holter. The ECHO test showed something called grade 1 diastolic dysfunction, and the ECG came up with sinus tachycardia. Thankfully, the Holter test was normal. Should...

Accepted Answer

based on your test results, it seems like you have grade 1 diastolic dysfunction, sinus tachycardia, and a normal Holter report. Grade 1 diastolic dysfunction is the mildest form of diastolic dysfunction and may not cause any symptoms. To help reverse diastolic dysfunction, it is important to focus on lifestyle changes such as maintaining a healthy weight, eating a balanced diet low in salt, exercising regularly, managing stress, and avoiding smoking and excessive alcohol consumption. In terms of medication, your doctor may prescribe medications such as ACE inhibitors like Lisinopril or ARBs like Losartan to help improve heart function. It is also important to follow up with your doctor regularly to monitor your condition and make any necessary adjustments to your treatment plan. If you have any concerns or notice any new symptoms, please consult your healthcare provider for further evaluation and management."

Question 6

Is a heart rate of 108 bpm something I should be worried about? I'm seeing something called sinus tachycardia in my report, and I'm not sure if it's dangerous or just something common. Could you clarify this for me?

Accepted Answer

A heart rate of 108 beats per minute (bpm) falls within the range of sinus tachycardia, which means that the heart is beating faster than normal. Sinus tachycardia can be a common response to various factors such as stress, anxiety, caffeine, or physical activity. However, if it persists or is associated with symptoms like dizziness, chest pain, or shortness of breath, it may require further evaluation. In cases of persistent or symptomatic sinus tachycardia, treatment may involve addressing the underlying cause. Beta-blockers such as Metoprolol can be prescribed to help slow down the heart rate and reduce symptoms. The typical dosage of Metoprolol for sinus tachycardia is 25-100mg twice daily, but the exact dosage should be determined by a healthcare provider based on individual factors.

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