Question 1

What are the 4 stages of heart failure?

Accepted Answer

Stage 1:Cardiac disease but no symptoms and no physical limitations in ordinary activity. Stage 2: Mild symptoms and slight limitation in physical activity. Stage 3: Siginificant limitation in physical activity due to symptoms, comfortable ony at rest. Stage 4: Severe limitaitons, symptoms even at rest.

Question 2

I'm really concerned about some recent findings on my coronary vessels. I've got an 80% lesion in the LAD vessel from the proximal to the mid-long segment, and then a 70% lesion in the distal long segment. Plus, there's a 90% lesion at the ostium of the D1 small vessel. On top of that, my RCA vessel has a total 100% blockage, but it's still somehow filling via bridging collaterals and retrogradely through the left coronary injection. Should I be worried about these percentages and the way my heart is compensating? What kind of treatment might be recommended in this situation?

Accepted Answer

The condition you have described is quite serious and involves multiple blockages in your coronary arteries. To address the blockages, a combination of medications and procedures may be necessary. For the 80% lesion in the ostial portion of the LAD 3 vessel, a stent placement procedure may be considered to improve blood flow. Similarly, for the 70% lesion in the proximal to mid long segment of the LAD 3 vessel, another stent placement or angioplasty may be recommended. The 80% lesion in the distal long segment of the LAD 3 vessel may also require intervention such as stenting. For the D1 small vessel with a 90% lesion, a stent placement or angioplasty may be necessary to restore blood flow. The RCA vessel with a 100% lesion in the mid portion may require more aggressive treatment such as bypass surgery. In the meantime, medications like aspirin, clopidogrel, statins, beta-blockers, and ACE inhibitors may be prescribed to manage your condition and reduce the risk of further complications. Regular follow-up with your cardiologist is crucial to monitor your progress and adjust your treatment plan as needed.

Question 3

I've noticed my heart rate drops to around 41-45 when I'm sleeping, and I'm a bit worried about it. I'm currently taking Ivabradine, 5mg twice a day. During the day, my heart rate is generally between 85-90, and it goes up to 105-110 while I'm walking. I started on Ivabradine because my heart rate would hit 150 with just minimal exertion. Is it normal for my heart rate to drop like that while I'm asleep, or should I be concerned?

Accepted Answer

A heart rate dropping to 41-45 while sleeping can be concerning, especially if you are already on Ivabradine for high heart rate during the day. Since Ivabradine is a medication that helps lower heart rate, it is important to monitor your heart rate closely. In your case, since your heart rate during the day is around 85-90 and 105-110 while walking after taking Ivabradine, it seems like the medication is working to lower your heart rate effectively. However, a heart rate dropping significantly during sleep may warrant further evaluation. I recommend discussing this with your healthcare provider to determine if any adjustments to your medication dosage or timing are needed. It's important to ensure that your heart rate remains within a safe range even during sleep.

I've been checking my heart rate with my phone, and it usually reads between 90-100. I don't smoke, drink, or experience any stress, but sometimes my heart feels a bit heavy, even when I'm just resting. Is this normal? I'm 5.9 tall and weigh 75 kg.

An echo and ecg is advised.

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