Question 1

I'm really worried about some health stuff. I recently took a test that showed mild PAH, and I'm wondering if that's something I need to be concerned about. Ever since I moved to India from Australia, my anxiety has gotten really bad. I've had a pulse of 134 a few times, especially during the lockdown and just yesterday because I was so tense. I'm 33, 4 ft 8 in, and weigh 44 kilos. I eat really healthily, avoiding processed foods and carbs. Should I be worried about these things or am I overthinking it?

Accepted Answer

Mild pulmonary arterial hypertension (PAH) can be a cause for concern, but its impact varies depending on the underlying cause and overall health. Elevated heart rates during periods of tension and anxiety are not uncommon and can exacerbate feelings of discomfort. Given your history of anxiety, its important to manage stress effectively and monitor your heart health.

Since you have a history of mild PAH and experience significant anxiety, it would be beneficial to discuss this with your cardiologist and possibly a mental health professional. They can help monitor your condition and provide strategies to manage anxiety, which can, in turn, help stabilize your heart rate. Techniques such as mindfulness, cognitive-behavioral therapy (CBT), or medication might be recommended.

Question 2

I've been told by my doctor that I need a CT angiography, but because of my sinus tachycardia, he mentioned it might be hard to do. I'm already taking beta-blockers and sedatives, but my heart rate is still not under control at the doctor's office. I'm worried about how I can manage my heart rate so I can get the CT angio done. What should I do?

Accepted Answer

To manage your heart rate for CT angiography despite sinus tachycardia, you can consider using a calcium channel blocker such as Diltiazem. The recommended dosage for Diltiazem in this case would be 120-360 mg per day. This medication can help in controlling your heart rate and making it feasible to undergo the CT angiography procedure. Additionally, you may also benefit from the use of a medication like Atenolol, a beta blocker, at a dosage of 25-100 mg per day to further help in controlling your heart rate during the procedure. It is important to follow your doctor's guidance and dosage instructions carefully.

Question 3

So my 76-year-old mom, who's diabetic, has been diagnosed with a triple vessel block and just had an acute anterolateral wall MI. I'm really worried and trying to figure out whether a stent or a bypass would be the better option for her. Could you help me understand the pros and cons of each? I'm kind of at a loss here and would really appreciate your guidance.

Accepted Answer

For a 76-year-old diabetic patient with triple vessel blockage and acute anterolateral wall MI, treatment options include:

Stent Placement

1. Percutaneous Coronary Intervention (PCI): Stenting can improve blood flow, but may require multiple procedures.
2. Advantages: Minimally invasive, quicker recovery.
3. Disadvantages: Higher restenosis risk, potential for stent thrombosis.

Bypass Surgery (Coronary Artery Bypass Grafting - CABG)

1. Surgical option: Bypass grafts reroute blood flow around blocked arteries.
2. Advantages: Higher success rate, lower restenosis risk, suitable for complex cases.
3. Disadvantages: Invasive, longer recovery, potential for graft failure.

I've been using beta blockers for my anxiety, mainly because of heart palpitations. I'm thinking about stopping them, but I'm a bit anxious about the right way to do it safely. What's the best approach to taper off them without causing issues?

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