Question 1

I'm a bit worried because I've been diabetic for 35 years and have managed it pretty well until now, but recently, I've started experiencing this sinking feeling and episodes of fainting and dizziness. I got an ECG done and it shows some blockage. Could this be related to my diabetes, and what should I do next?

Accepted Answer

Given your 35-year history of well-managed diabetes, the recent symptoms of sinking feeling, fainting, and dizziness, along with ECG indications of blockage, suggest a potential cardiovascular issue, such as coronary artery disease or cardiac autonomic neuropathy, so consult a cardiologist to discuss further testing, like angiography or stress tests, and develop a plan to address the blockage and manage cardiovascular risk factors.

Question 2

My dad's angiogram showed a 95% block in his LAD, but the SPECT test said only 25-30% of his heart muscle is viable. The PET CT later showed 60% hibernating myocardium that's still viable. Should we go for revascularization, and if so, would a stent or bypass be better? What are the risks, or can we just stick to meds since he's stable right now?

Accepted Answer

Medicine is very important before and after procedure but it's not enough in this case Lucky no pain gives you time but few of left myocardial muscle will die if we don't give blood to it so sitting on it is not a good idea Than should not have done all scans because now they are telling you to act upon Single block easily removed by stent takes ten minutes and. 20 years results comparable to bypass . I would get myself cut for no reason Bypass is optional if stent can't be done or too many blocks

Question 3

I'm in a bit of a dilemma here. All of my tests, like ECG, echo, TMT, and chest X-ray, came back normal except for high LDL cholesterol. So the doctor put me on Rosuvas, which I've been taking. But now, after a month of feeling okay, the chest pain and tightness are creeping back. I remember the doctor saying to take BP meds if this happened, but I'm not sure which one to pick. My weight is around 110 kg, and my blood pressure was 14090 last month, but I can't check it now because of the lockdown. Should I stick with the Metoprolol I got last year, or should I go out and get Amlopidine? Which one would be better in this situation?

Accepted Answer

"Based on your symptoms of chest pain and tightness, and your history of high LDL cholesterol, it is important to manage your blood pressure effectively. Considering your weight and previous blood pressure reading of 14090, you can take amlodipine to help lower your blood pressure. Amlodipine is a calcium channel blocker that can help relax the blood vessels, making it easier for the heart to pump blood. Since you already have metoprolol with you, you can also consider taking it as it is a beta-blocker that can help lower blood pressure and reduce chest pain. The usual dosage of metoprolol for high blood pressure is 25-100mg once or twice daily. However, please note that metoprolol may not be as effective in controlling chest pain compared to amlodipine. If you choose to take metoprolol, start with a lower dose and monitor your blood pressure closely. If your symptoms persist or worsen, it is important to seek medical advice promptly. Additionally, try to monitor your blood pressure regularly, especially during this time when access to healthcare may be limited due to the lockdown."

I'm really concerned about my mom. She's got a heart rate that's sitting at 100 bpm. What can we do to bring it down to a normal range? Could you suggest any steps, actions, or medications that might help?

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