Question 1

I'm really worried about someone who recovered from COVID three weeks ago but is still dealing with a persistent cough and some chest congestion. What concerns me more is that just yesterday, their heart rate shot up to 117, and even though it's come down to around 95 after taking one Evapump tab, I'm unsure if it's safe to use this medication whenever their pulse rate spikes. They tested negative for COVID twice with RT PCR recently. About two weeks ago, there was another incident where their pulse rate went all the way up to 157, with a blood pressure reading of 131 over 82. Can you let me know if these fluctuations are something to be concerned about and if this medication is the right way to manage it?

Accepted Answer

ascoril syrup

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'm a bit worried about my TMT results that showed inducible ischemia and mentioned a 1 mm ST change in certain leads during exercise. My max heart rate reached 206, with a maximum blood pressure of 18580, and I'm only 33 years old. I exercised for a total of 6 minutes and 19 seconds, reaching a workload of 7.40 METS, but the test was stopped when I hit my max heart rate. My 2D Echo came back normal. Do you think I need to get an angiogram, or is there anything else I should consider?

Accepted Answer

Given your positive TMT result showing inducible ischemia with 1 mm ST depression in multiple leads, achieving maximum heart rate during the test, and normal 2D Echo results, an angiogram may be recommended to further evaluate the extent and severity of coronary artery disease, especially considering your young age (33) and high workload achieved during the test; consult your cardiologist to discuss the risks and benefits of an angiogram and determine the best course of action.

A colour doppler flow venous test is advised to the patient and cardiac opinion ..

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