Question 1

I'm really worried about my father. He's been diagnosed with severe coronary ectasia and previously, doctors mentioned that a bypass surgery isn't an option for him. I'm wondering if treatments like Ace Inhibitors or the drug Entresto could be effective in his situation? Lately, he's been having more frequent chest pains and feeling a lot of unease. Could you provide some guidance on this?

Accepted Answer

For the treatment of coronary ectasia, Ace Inhibitors such as Lisinopril can be beneficial in managing symptoms and improving heart function. The recommended dosage of Lisinopril is usually starting at 2.5-5 mg once a day, which can be adjusted by the doctor based on individual response. Entresto, which is a combination of Sacubitril and Valsartan, can also be considered for the treatment of heart failure in patients with reduced ejection fraction. The usual starting dose of Entresto is 4951 mg twice daily, which can be increased to the target maintenance dose of 97103 mg twice daily as tolerated. However, it is important to consult with your father's healthcare provider before starting any new medication or making changes to his current treatment plan. Regular monitoring and follow-up with a healthcare professional are essential in managing coronary ectasia and associated symptoms.

Question 2

I'm really puzzled about something and could use some guidance. All my testsECG, echo, and TMTcame back normal, yet I'm experiencing this weird pain in my chest muscle, especially when I touch it or sit down. There's also this mild pain below my collarbone and at the back of my left rib when I touch those areas. It almost feels like there's some swelling right below my left collarbone, but everything looks normal when I check in the mirror. Any idea what might be going on?

Accepted Answer

Based on your description, it seems like you may be experiencing musculoskeletal chest pain rather than a cardiac issue since your ECG, echo, and TMT are normal. The pain you are feeling when touching your chest muscles and the mild pain below the collar bone and back side of the left rib could be due to muscle strain or inflammation. To help relieve the pain and swelling, you can try taking over-the-counter pain relievers such as acetaminophen. Additionally, applying a warm compress to the affected area and gently massaging the muscles may also provide some relief. If the pain persists or worsens, it would be advisable to consult with a doctor for further evaluation and management.

Question 3

I'm really worried about my mom. Her blood pressure this morning was 16090, and she's gained 45 kgs in the last 7 months. She doesn't show any other symptoms, but should I be concerned? Do you think she should start on any medication, or is there something else I should do? I'm planning to keep track of her blood pressure from now on. What would you recommend?

Accepted Answer

High blood pressure (hypertension) can lead to serious health issues if left untreated. Given your mother's blood pressure reading of 16090, it is considered high and should be monitored closely. Since she has also gained weight recently, it is important to address this as well to help lower her blood pressure. I recommend starting with lifestyle modifications such as regular exercise, a healthy diet low in sodium and saturated fats, and weight loss if needed. Additionally, she can start taking an antihypertensive medication such as Losartan 50mg once daily to help lower her blood pressure. However, it is important to consult with a healthcare professional for proper evaluation and monitoring.

I'm really concerned about my mom's health. Her ESR levels are incredibly high, sitting at 155, and she's been struggling with rheumatoid arthritis. Could you help me understand whether this is something we should be worried about and what potential impacts this might have on her condition?

Causes of high esr includes infections like t.b, hepatitis, cancer , bacterial ifections, anaemia and arthritis..etc.. other investigations include RA factor and anti ccp tests is advised..

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