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A Close Friend's Recent Angiogram Test Due To A Weak
Question: A close friend's recent angiogram test due to a weak and enlarged heart shows no artery blockage. Another test shows pulmonary edema, and she was diagnosed gastritis -- now slowly recovering. She recurrently feels "not well" in a way that is hard to describe. Could her combination of medications be the source of this trouble (lasix, amlodipine, lanoxin, eliquis, Telmisartan, lamivudine, and blood thinner)? If the medications are not the source of her recurrently “feeling not well”, what condition(s) does the attached collection of reports suggest? Thanks in advance.
Brief Answer:
Dilated cardiomyopathy
Detailed Answer:
Hello
After going through the medical details and the reports attached by you I can very well understand your concern for your friends health and I would like to tell you that basically she’s having dilated cardiomyopathy which is the third most common cause of heart failure in cardiac patients.
The sense of not being well, easy fatigue, laziness etc are all due to her weakened heart and not because of the medication. Her pumping ability of the heart is just around 20 to 25% as per the Echocardiography report which is significantly on the lower side (normal is above 55).
The pulmonary edema which she developed is also because of low pumping of the heart.
Things which she need to take care is to avoid unnecessary exertion, have to limit daily fluid intake to not more than 1.5 ltrs a day, low salt diet, strictly no smoking, limit coffee and other caffeine containing drinks and follow healthy lifestyle routine and most importantly take medications regularly and timely.
I hope this information will guide you properly.
Kind Regards
Dr Bhanu Partap
Dilated cardiomyopathy
Detailed Answer:
Hello
After going through the medical details and the reports attached by you I can very well understand your concern for your friends health and I would like to tell you that basically she’s having dilated cardiomyopathy which is the third most common cause of heart failure in cardiac patients.
The sense of not being well, easy fatigue, laziness etc are all due to her weakened heart and not because of the medication. Her pumping ability of the heart is just around 20 to 25% as per the Echocardiography report which is significantly on the lower side (normal is above 55).
The pulmonary edema which she developed is also because of low pumping of the heart.
Things which she need to take care is to avoid unnecessary exertion, have to limit daily fluid intake to not more than 1.5 ltrs a day, low salt diet, strictly no smoking, limit coffee and other caffeine containing drinks and follow healthy lifestyle routine and most importantly take medications regularly and timely.
I hope this information will guide you properly.
Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Dr. Partap. In my last communication I sent along my sincere thanks for your helpful report, which I have passed on to my friend. Can you help on two matters that have come in conversations about cardiomypotahy. (1) First, if she pursues the life-style corrections and the medications (the ones she has been directed to take) over several months, can we expect the heart function (pumping effectiveness in the left ventricle) to improve, or is her most attainable goal that of preventing the effectiveness from getting worse? (2) Concerning dilated cardiomyopathy, is there a medication (or class of medications) that are designed to make that condition less severe? (I am thinking of a medication that she is not taking now.) Thanks in advance for your consideration.
Brief Answer:
follow-up
Detailed Answer:
Hello Again,
Thanks for your appreciation, it means a lot.
1. Yes, there are good possibilities that her cardiac function will improve with proper lifestyle routine, regular medications and timely follow-ups with treating doctor.
2. As her Angiography was normal I would like to suggest you discuss with her treating cardiologist regarding the possibilities of starting a drug called 'Vymada'. It’s a newer drug and has shown very good results in improving cardiac pumping in patients with low ejection fraction over a period of a couple of months.
Kindly discuss this with your cardiologist.
I hope this information will guide you properly.
Kind Regards
Dr Bhanu Partap
follow-up
Detailed Answer:
Hello Again,
Thanks for your appreciation, it means a lot.
1. Yes, there are good possibilities that her cardiac function will improve with proper lifestyle routine, regular medications and timely follow-ups with treating doctor.
2. As her Angiography was normal I would like to suggest you discuss with her treating cardiologist regarding the possibilities of starting a drug called 'Vymada'. It’s a newer drug and has shown very good results in improving cardiac pumping in patients with low ejection fraction over a period of a couple of months.
Kindly discuss this with your cardiologist.
I hope this information will guide you properly.
Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thanks for your very helpful information, Dr. Partap. Your note will encourage her to be serious about the needed life-style improvements -- and they are very badly needed (whether or not she has a heart condition).
I need to send you this important follow-up, please. Since my friend already has chronic low blood pressure (probably due to a medication she is now taking, since she once had chronic high blood pressure), to take Vymada she would have to be taken off her current blood pressure medication. No?
Also, she may also need to stop Lasix, according the info. at this page: https://www.drugs.com/drug-interactions/sacubitril-valsartan.html . No?
Finally, do you know of a route whereby a pharmacy in XXXXXXX would accept a prescription from her doctor (and ship it to Canada)? I ask because there is no way her family could afford the USA price of $9.0 per tablet for Entresto (which seems similar to Vymada.).
Thanks in advance, Dr. Partap.
I need to send you this important follow-up, please. Since my friend already has chronic low blood pressure (probably due to a medication she is now taking, since she once had chronic high blood pressure), to take Vymada she would have to be taken off her current blood pressure medication. No?
Also, she may also need to stop Lasix, according the info. at this page: https://www.drugs.com/drug-interactions/sacubitril-valsartan.html . No?
Finally, do you know of a route whereby a pharmacy in XXXXXXX would accept a prescription from her doctor (and ship it to Canada)? I ask because there is no way her family could afford the USA price of $9.0 per tablet for Entresto (which seems similar to Vymada.).
Thanks in advance, Dr. Partap.
Brief Answer:
Hello again
Detailed Answer:
Apologies for the delayed response.
She can safely take the medication if her systolic blood pressure stays above 100 mmHg. Lasix can be taken along but blood pressure need to be monitored properly. Also a close watch on her potassium level is also required.
$9 for one Tablet is way to expensive, you need to give me a day or two time so as to figure out something if the medication can be sent from here or not.
Will surely try to help you out with this.
Kind Regards
Dr Bhanu Partap
Hello again
Detailed Answer:
Apologies for the delayed response.
She can safely take the medication if her systolic blood pressure stays above 100 mmHg. Lasix can be taken along but blood pressure need to be monitored properly. Also a close watch on her potassium level is also required.
$9 for one Tablet is way to expensive, you need to give me a day or two time so as to figure out something if the medication can be sent from here or not.
Will surely try to help you out with this.
Kind Regards
Dr Bhanu Partap
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Kampana
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