Re: 94 Year Old Woman. Otherwise In Good Health, But

Posted on Mon, 4 Jan 2021

Question: Re: 94 year old woman. Otherwise in good health, but for some blood pressure meds (Norvask), she had a heart attack and underwent a double stent procedure which appears to successful, we about 10 days post procedure. We are concerned about some side effects of the new medications, being Metropolol (beta block), Avastin (statin) and a blood thinner. We understand the blood thinner is a must take drug, the side affects of confusion, halucination, and shortness of breath seem correlated to the statin and blocker respectively. We have stopped the statin, the halucinations stopped. We stopped the metropolol for a day, and the shortness of breath stopped. Can we do just the blood thinner and be ok if that is what is tolerated? We are concerned that if her blood pressure spikes, stopping and starting Metropolol has risk, and yet if that happens we would have no other prescribed meds, and our Doctors here are not returning our calls, going on holidays, etc. If her blood pressure spikes without Metropolol, can we use the old Norvask? I know we will need proper consultations, but as of now we are unable to actually get help and will be making our own judgements by necessity. She is doing well otherwise, and no way would we take her to emerg with covid restrictions etc. I am in Canada, and our helath system right now is not functioning.

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome on - Ask a Doctor - service!

I passed carefully through your concern and would like to explain that your decision to stop Metoprolol and statin seems rationale as their use is associated with serious adverse effects. In the mean time I recommend careful continuation of antithrombotic medication as it is important to control potential thrombotic complications.

Considering her actual complaint of shortness of breath, it would be necessary to check her cardiac function by performing a cardiac ultrasound. This could give us important information on possible reduced (ejection fraction) cardiac function and properly guide on additional treatment .

A water pill ( diuretic) medication could be helpful to relieve her breathing .

Anyway, as the actual pandemic restrictions make this strategy difficult to follow, you may try the available calcium channel blocker : Norvasc , to better control her high blood pressure, until a direct medical consultation is possible.

I recommend starting with 5mg Norvasc daily and closely check her blood pressure values to guide on further dose adjustements.

Hope to have been helpful to you!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka, Cardiologist

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar