Question 1

I've been checking my blood pressure with a monitor, and every time the cuff gets tighter, I start feeling some chest pressure. It's not super strong, but I definitely notice it, and it happens every time I check. My blood pressure was 12588. I'm also worried because I get chest pains sometimes. What could be causing this?

Accepted Answer

The sensation of chest pressure when the blood pressure cuff is tightened could be due to increased pressure on the chest wall. However, since you also mentioned that you experience chest pains sometimes, it is important to monitor this closely. With a blood pressure reading of 12588, it is within the prehypertension range. To help manage your blood pressure and chest discomfort, you can take a low dose of Amlodipine (brand name: Norvasc) 5mg once daily. Additionally, it is advisable to follow up with your healthcare provider for further evaluation and management.

Question 2

For how long can we rely on the CT coronary angio results? My mom is 65, diabetic, and had one done in February 2020it all looked pretty normal back then, no plaque in the main artery and a calcium score of zero. Her recent ECG also came back normal and she's not having any symptoms, but we've found that she has mild pulmonary hypertension with a systolic pressure of 34 mmHg on a 2D echo. She's not taking any blood thinners right now. Do you think we should consider repeating the CT angio?

Accepted Answer

CT coronary angiography is a non-invasive imaging test that can provide detailed information about the coronary arteries. In your mother's case, since her CT angio done in Feb 2020 showed a fairly normal result with no plaque in the main artery and a calcium score of zero, it indicates a low risk of significant coronary artery disease at that time. Given that the recent ECG is normal and your mother has no complaints, the decision to repeat the CT angio should be based on her current symptoms, risk factors, and overall clinical condition. Mild pulmonary hypertension as seen in the 2D echo with a systolic pressure of 34 mmHg may not necessarily warrant a repeat CT angio unless there are new symptoms or concerns regarding her cardiac health. It is important to continue monitoring her condition regularly with follow-up visits to her healthcare provider, who can assess the need for any further investigations or adjustments to her treatment plan.

Question 3

I'm a bit confused about my liver function test results. My total cholesterol is at 230, and I've gotten different opinions from doctors. Some suggest medication, while others say it's nothing to worry about. Should I be concerned about this level? When exactly should I start taking action or medication?

Accepted Answer

A total cholesterol level of 230 is considered borderline high, which means you're at risk of developing heart disease. The American Heart Association recommends aiming for a total cholesterol level below 200 milligrams per deciliter (mgdL).

Here are some conditions where you should take care:

Liver-Related Conditions

- Fatty Liver Disease: Excess fat accumulation in liver cells can disrupt liver function and increase cholesterol levels.
- Non-Alcoholic Steatohepatitis (NASH): A more severe form of fatty liver disease characterized by inflammation and scarring.
- Cirrhosis: Late-stage liver disease where liver tissue is replaced by scar tissue, affecting cholesterol metabolism [1).

Lifestyle Changes

To manage your cholesterol levels:

- Exercise Regularly: Aim for 150 minutes of moderate-intensity exercise weekly.
- Follow a Healthy Diet: Focus on whole grains, fruits, vegetables, and lean protein sources.
- Maintain a Healthy Weight: Excess weight contributes to high cholesterol [1).

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