Question 1

My father is 66 and has been diagnosed with triple vessel coronary artery disease with 90% stenosis in his right coronary artery and 70-80% blockages in his LCX and LAD. He chews tobacco and occasionally smokes, plus he has diabetes and slightly high blood pressure. Doctors suggested either angioplasty or bypass surgery which option would be better for him given his condition?

Accepted Answer

For a 66-year-old with triple vessel coronary artery disease, 90% stenosis in the right coronary artery, and 70-80% blockages in the LCX and LAD, plus risk factors like tobacco use, diabetes, and high blood pressure, bypass surgery (CABG) is likely the better option compared to angioplasty with stenting

Question 2

I'm a bit concerned after my recent doctor visit. I had some left shoulder pain and my hands felt a bit numb after traveling, so I went to get checked out. The doctor had me do an ECG and mentioned that the QRS interval was 119ms, along with some other abnormalities, then suggested an echo just to be sure. The echo results seemed alright, showing no PAH or RWAH, and my LV systolic and diastolic function looks fine with an EF of 68. They didn't find any clots or vegetation, and the doctor said my echo is fine, but I'm still worried about the QRS interval on my ECG. Should I be looking deeper into this, or is it nothing too concerning?

Accepted Answer

The ECG report showing a QRS interval of 119ms may indicate a slight delay in the electrical conduction through the heart's lower chambers. This could be due to various reasons such as conduction abnormalities or certain heart conditions. However, since your screening echo came back normal with no significant findings, it is less likely to be a cause for concern. To alleviate your left shoulder pain and numbness in hands, you can take over-the-counter painkillers such as ibuprofen (e.g., Advil) at a dose of 400mg every 4-6 hours as needed for pain relief. Additionally, you can also consider using topical pain relief creams such as diclofenac gel for localized relief. It is always advisable to follow up with your doctor for further evaluation and management based on your individual health condition.

Question 3

I've been having this tightness in my chest and feeling really tired, plus I'm not sleeping well at all. It's also making my mood all over the place and I'm dealing with some shortness of breath too. Could these symptoms be connected? Should I be concerned or is this something that will pass on its own?

Accepted Answer

You may be experiencing symptoms of anxiety or stress. To help with these symptoms, you can try taking over-the-counter medication such as lorazepam (Ativan) 1mg as needed for anxiety. Additionally, practicing relaxation techniques, such as deep breathing exercises or meditation, may also be beneficial. If symptoms persist, it is important to consult with a healthcare professional for further evaluation and management.

I'm really concerned about the long-term effects of beta blockers for managing hypertension. I've heard they might raise blood sugar and cholesterol levels. Can you suggest which beta blocker is the safest and has the least side effects?

Visit your Physician for evaluation and appropriate management

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