Question 1

I'm really puzzled about my situation. I've been getting a stress positive result on my TMT test for the last five years, even though my angiogram came back normal and I don't have any heart issues. I'm just wondering what steps I can take or medicines I might need to help me eventually get a stress normal result. Could you give me some advice on this?

Accepted Answer

Albumin++ in your urine routine test indicates proteinuria, a sign of kidney damage or disease.

_Causes_

1. Kidney damage (nephropathy)
2. Diabetic nephropathy
3. Hypertension
4. Kidney stones
5. Urinary tract infection

_Treatment_

1. _Consult a nephrologist_: Schedule an appointment with a kidney specialist.
2. _Underlying cause treatment_: Address the underlying condition causing proteinuria.
3. _Medications_:
    - ACE inhibitors or ARBs to reduce proteinuria and blood pressure.
    - Diuretics to manage edema and blood pressure.
4. _Lifestyle modifications_:
    - Monitor and control blood pressure.
    - Manage blood sugar levels (if diabetic).
    - Reduce protein intake.
    - Increase fluid intake.
    - Exercise regularly.
    - Quit smoking.

_Follow-up tests_

1. Repeat urine tests to monitor proteinuria.
2. Blood tests to evaluate kidney function (eGFR, creatinine).
3. Imaging tests (ultrasound, CT scan) to assess kidney damage.

Question 2

I'm really worried about this chest pain I've been having. It's been going on for about a month now, right where I can feel my heartbeat. It's been getting worse over the past few days, and it even hurts when I laugh or move my left hand. I did see a doctor when it was less painful, and they said it was muscular pain, but I'm honestly not convinced. I didn't lift anything heavy or suffer any injury, and it's just that specific spot that hurts. Could this be something more serious than muscular pain?

Accepted Answer

It sounds like you may be experiencing symptoms of angina, which is chest pain or discomfort caused by reduced blood flow to your heart muscle. Since the pain has been increasing and is now triggered by laughing or moving your left hand, it's important to take it seriously. I recommend taking a low dose of aspirin (75-100mg) as a precautionary measure to help reduce the risk of a heart attack. Additionally, you should follow up with your doctor for further evaluation and possibly consider an ECG to rule out any heart-related issues.

Question 3

My father is 66 and has been diagnosed with triple vessel coronary artery disease with 90% stenosis in his right coronary artery and 70-80% blockages in his LCX and LAD. He chews tobacco and occasionally smokes, plus he has diabetes and slightly high blood pressure. Doctors suggested either angioplasty or bypass surgery which option would be better for him given his condition?

Accepted Answer

For a 66-year-old with triple vessel coronary artery disease, 90% stenosis in the right coronary artery, and 70-80% blockages in the LCX and LAD, plus risk factors like tobacco use, diabetes, and high blood pressure, bypass surgery (CABG) is likely the better option compared to angioplasty with stenting

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