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My Father Who Is 78 Years Old Is Suffering From
Question: My father who is 78 years old is suffering from chest pain since last 4 days. He has no known heart disease until now except for hypertension for several years for which he regularly takes Minipress2.5 XL His echo report during a routine heart check in Nov 2019 was fine. Yesterday we consulted the doc who advised E C G and Echo and there are some abnormalties. Based on the result , the cardio gave medicines and tecommended angiography. Due to the covid 19 outbreak i would prefer to avoid any procedure for 4-5 months till this outbreak subsides and manage with medicines..what is your advice.
Brief Answer:
Kindly send the ECG and Echo reports
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer Maheshwari, cardiologist.
A Decrease in heart function and sudden abnormality in Echo and ecg can mean a heart attack.
I would like you to send the ECG and Echo so that I can guide you ahead.
Thanks and regards
Kindly send the ECG and Echo reports
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer Maheshwari, cardiologist.
A Decrease in heart function and sudden abnormality in Echo and ecg can mean a heart attack.
I would like you to send the ECG and Echo so that I can guide you ahead.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Doc , i have already attached the echo, ecg and blood reports of yesterday.please check attachments
Sir, waiting for your urgent response
Brief Answer:
Needs intervention soon
Detailed Answer:
Hi,
Welcome back.
The ECG and echo shows that he had a heart attack leading to decreased heart pumping (currently it is 40%).
Now you have to tell me whether the pain is still ongoing or has it stopped. If the pain is still there, he needs angiography which has to be done soon.
The Injection Fondared has to be given 5mg and not 2.5mg for at least 7 days.
You can take him to a hospital with less number of high risk patients where it is safe to do the intervention.
You can come here to our hospital in XXXXXXX where we don't have any Corona cases.
Rest the medicine are fine.
Continue them till you go for intervention.
Thanks and regards.
Needs intervention soon
Detailed Answer:
Hi,
Welcome back.
The ECG and echo shows that he had a heart attack leading to decreased heart pumping (currently it is 40%).
Now you have to tell me whether the pain is still ongoing or has it stopped. If the pain is still there, he needs angiography which has to be done soon.
The Injection Fondared has to be given 5mg and not 2.5mg for at least 7 days.
You can take him to a hospital with less number of high risk patients where it is safe to do the intervention.
You can come here to our hospital in XXXXXXX where we don't have any Corona cases.
Rest the medicine are fine.
Continue them till you go for intervention.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
His pain has stopped for now. Also I understand that the injection should be given 5mg for 7 days.
So, If there is no pain, can we continue with the other meds for few months till this corona situation improves?
So, If there is no pain, can we continue with the other meds for few months till this corona situation improves?
Brief Answer:
Detailed answer ahead
Detailed Answer:
Hi,
Welcome back.
You can continue with the medical management as of now if the pain is gone. If the pain reoccur or increase than you have to go to the hospital.
The problem with medical management with ongoing heart attack is that heart pumping can deteriorate further because of the low blood supply that area whose blood vessel is blocked.
If you want to continue with medicine as of now-
Change Ecosprin Gold to Deplatt-A 75/75mg once a day, Tab Atorvastatin 80mg once daily (Ecosprin gold has 20mg Atorvastatin, but dose needed for now is 80mg).
Monitor BP and if it is ok than Betaloc can be increased to 50mg twice daily and
add Tab Angispan TR 2.5mg twice daily-9am-5pm (it is a blood vessel dilator which helps keep blood vessel open and improve symptoms),
Tab Lasilactone 20/50mg once a day at 9am (as the heart pumping is low, it is needed otherwise he will develop problem in breathing, it is a diuretic which will increase urine output).
Another important medicine is Tab Ramipril which help helps improve heart pumping and should be started with 2.5mg once a day if kidney function is normal (normal creatinine) and he does not have low BP.
You should go to the hospital if pain increase or he has problem in breathing.
Thanks and regards
Detailed answer ahead
Detailed Answer:
Hi,
Welcome back.
You can continue with the medical management as of now if the pain is gone. If the pain reoccur or increase than you have to go to the hospital.
The problem with medical management with ongoing heart attack is that heart pumping can deteriorate further because of the low blood supply that area whose blood vessel is blocked.
If you want to continue with medicine as of now-
Change Ecosprin Gold to Deplatt-A 75/75mg once a day, Tab Atorvastatin 80mg once daily (Ecosprin gold has 20mg Atorvastatin, but dose needed for now is 80mg).
Monitor BP and if it is ok than Betaloc can be increased to 50mg twice daily and
add Tab Angispan TR 2.5mg twice daily-9am-5pm (it is a blood vessel dilator which helps keep blood vessel open and improve symptoms),
Tab Lasilactone 20/50mg once a day at 9am (as the heart pumping is low, it is needed otherwise he will develop problem in breathing, it is a diuretic which will increase urine output).
Another important medicine is Tab Ramipril which help helps improve heart pumping and should be started with 2.5mg once a day if kidney function is normal (normal creatinine) and he does not have low BP.
You should go to the hospital if pain increase or he has problem in breathing.
Thanks and regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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