Question 1

I'm having some trouble with mild heart palpitations and anxiety, so my cardiologist put me on Telma 40 and propranolol 40 mg. The good news is my palpitations and angina are gone since starting propranolol, but now I'm experiencing some erection issues. I'm wondering, could I switch from propranolol to Nevivolol? Or would it be okay to take tadalafil along with the propranolol? Could you give me some advice on these two options?

Accepted Answer

1. Instead of Propranolol 40 mg, you can use Nebivolol. The recommended dosage for Nebivolol is 5 mg to 10 mg once daily. It is also effective in managing heart palpitations and anxiety, with a lower risk of causing erectile dysfunction compared to Propranolol. 2. You can take Tadalafil with Propranolol, but it is important to consult with your cardiologist or healthcare provider before combining these medications. Tadalafil is used to treat erectile dysfunction, and the combination with Propranolol may help alleviate the erection problem you are experiencing. The usual starting dose of Tadalafil is 10 mg taken prior to anticipated sexual activity, with a maximum frequency of once per day.

Question 2

I've been having a tough time over the past couple of years with losing my job and family issues. Lately, I've been feeling this crushing sensation in my chest at times. A few years back, I was told I have mild mitral valve prolapse, but I never started any medication for it. I feel mild pain sometimes, but it never lasts more than two weeks. I'm trying to figure out if this chest pain is because of stress or my MVP. Ive also been feeling really down and anxious, especially at night, often ending up in tears. Some people close to me think I might have some psychological issues. What should I do?

Accepted Answer

It sounds like you are going through a lot of stress and emotional turmoil. The chest pain you are experiencing could be related to both stress and your history of mild mitral valve prolapse. It is important to address both the physical and emotional aspects of your health. For the chest pain related to mitral valve prolapse, you should consult with a doctor to determine if any medication or treatment is necessary. In the meantime, you can take over-the-counter pain relievers like acetaminophen to help with the pain. To address the stress and emotional issues you are facing, it would be beneficial to seek therapy or counseling to help you cope with your feelings of depression and anxiety. Additionally, practicing relaxation techniques such as deep breathing, meditation, or yoga can also be helpful in managing stress. In terms of medication, you can consider taking an antidepressant such as sertraline at a low dose to help with your depressive symptoms. It is important to consult with a doctor before starting any new medication to ensure it is safe for you. Remember to prioritize self-care, reach out to supportive friends and family members, and consider joining a support group to connect with others who may be going through similar experiences. Take care of yourself and know that it is okay to seek help when needed.

Question 3

I've been feeling this sharp pain on the left side of my chest, and it's got me worried. It seems to flare up whenever I climb stairs or if I try to sleep on my left side. Does this sound like anything serious? Should I be concerned about it, or is there something specific I should be doing to manage it?

Accepted Answer

Based on your symptoms, it is possible that you may be experiencing musculoskeletal pain or even a cardiac issue. However, it is important to rule out any serious conditions such as a heart attack. I recommend you to take an immediate ECG test and consult a cardiologist. In the meantime, you can take Acetaminophen 500mg for pain relief.

do ECG and proceed

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