Question 1

I'm really worried about my dad. He's 74 and had angioplasty six months ago, but now he's got another arterial block that's 70% blocked. The surgery's being delayed because his creatinine level is 3.2, which I believe is quite high, right? Also, he was on Brilinta, but they told him to stop because his platelet count dropped to 58,000. He's having chest pain now, and I'm wondering what we should be doing here? Is his health in serious risk? What steps should we take to manage this situation?

Accepted Answer

Given the patient's history of angioplasty, a 70% arterial blockage, elevated creatinine level of 3.2, and low platelet count of 58,000, the current chest pain is concerning and requires immediate medical attention. The discontinuation of Brilinta due to low platelet counts increases the risk of clot formation. The patient should be evaluated urgently by a cardiologist and a nephrologist to manage both the cardiac and renal issues. Alternative anti-platelet strategies may be needed, and continuous cardiac monitoring, possibly including a coronary angiogram, should be performed. A multidisciplinary approach involving cardiologists, nephrologists, and hematologists is essential to address the complexities of his condition

Question 2

I'm experiencing this weird needle-like pricking sensation in my right chest and arms, but it only happens at night, and Ive noticed it seems to occur when I drink alcohol. My blood pressure seems to range from 8095 to 120140 in the evening, but its normal in the morning. This has been going on for months now. I had an ECG done and the doctor said my heart seems fine, but he mentioned symptoms of high blood pressure over the past few months. Should I be worried about this, or is there something I could do to help with the symptoms?

Accepted Answer

This sensation in your right chest and arms, especially occurring at night after drinking alcohol, could be related to nerve irritation or inflammation. Given your fluctuating blood pressure readings, it is important to manage your blood pressure effectively to prevent any complications. I recommend you to take a low dose of Amlodipine (brand name: Norvasc) 5mg once daily to help control your blood pressure. Additionally, you can take Acetaminophen (brand name: Tylenol) 500mg for relief from the needle-like sensation in your chest and arms. However, it is important to limit or avoid alcohol consumption as it can exacerbate your symptoms and negatively impact your blood pressure. Please make sure to follow up with your doctor regularly to monitor your blood pressure and adjust your treatment plan as needed.

Question 3

I'm really worried about some recent health reports I've got. My TSH levels were high at 10.3, so my doctor increased my thyroid medication from 100mg to 125mg. Then after about 25 days, my TSH dropped to 0.70, and I was advised to cut down the medication to 75mg. I'm also confused because my TMT test came back positive for inducible myocardial ischemia, but my ECG and echocardiography were normal. The doctor is now suggesting I go for an angiogram. I'm really anxious about whether these thyroid level changes could be affecting my TMT results. Should I be rushing into getting the angiogram, and is there a real chance of having heart issues even though the ECG and echo were normal? Any advice would be really appreciated.

Accepted Answer

Yes  its is due to fluctating tsh levels. U may repeat angio after 6 months.

Can ECG detect heart problems?

An ECG may reveal abnormalities in heart rhythm, signs of blocked arteries or damage from a previous heart attack, or an enlarged heart.

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