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Suggest Treatment For BP, Diabetes And Breathlessness

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Posted on Tue, 27 Oct 2015
Question: Hi ,
This question is actually for my father who is 64 years old and he is suffreing from dibeties and blood pressuer but taking medecins for that. He is smooker. Now he is complaning about shortness of breath he had from 3-4 days ago and still having. We went to do blood tests and ECG (uploaded). He has done a Catheterization 10 years ago and installed a pillar. Please comment on the upploaded documents and advise if this is a pre sign of heart atttack or somthing diffirent ? Thanks
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I recommend some tests to exclude possible coronary artery syndrome

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I reviewed all his tests and would explain that his ECG reveals some extrasystoles (ectopic cardiac beats), which could be related to a cardiac arrhythmia possibly induced by cardiac ischemia.

His blood lab tests revel only slightly lower potassium levels, which could also be related to the ectopic heart beats.

His past medical history for diabetes, hypertension and a coronary stent, is really concerning about a possible coronary artery syndrome.

Besides cardiac ischemia in diabetes patient may not express itself with chest pain, but just a shortness of breath.

I recommend consulting with a cardiologist and performing a cardiac ultrasound and cardiac enzymes (Troponin, CK-MB), and NT pro-BNP.

I would recommend performing a functional tests to examine for possible coronary artery syndrome. The following tests would be useful:

- cardiac Angio CT scan
- echo stress test (dopamine)
- cardiac radionuclear perfusional tests
- 24-48 hour Holter test.

If ongoing cardiac ischemia is confirmed on the above tests, then a coronary angiography would be necessary (if cardiac enzymes result positive, this is the next step to be followed).

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

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

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

Cardiologist

Practicing since :2001

Answered : 9533 Questions

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Suggest Treatment For BP, Diabetes And Breathlessness

Brief Answer: I recommend some tests to exclude possible coronary artery syndrome Detailed Answer: Hello! Welcome and thank you for asking on HCM! I reviewed all his tests and would explain that his ECG reveals some extrasystoles (ectopic cardiac beats), which could be related to a cardiac arrhythmia possibly induced by cardiac ischemia. His blood lab tests revel only slightly lower potassium levels, which could also be related to the ectopic heart beats. His past medical history for diabetes, hypertension and a coronary stent, is really concerning about a possible coronary artery syndrome. Besides cardiac ischemia in diabetes patient may not express itself with chest pain, but just a shortness of breath. I recommend consulting with a cardiologist and performing a cardiac ultrasound and cardiac enzymes (Troponin, CK-MB), and NT pro-BNP. I would recommend performing a functional tests to examine for possible coronary artery syndrome. The following tests would be useful: - cardiac Angio CT scan - echo stress test (dopamine) - cardiac radionuclear perfusional tests - 24-48 hour Holter test. If ongoing cardiac ischemia is confirmed on the above tests, then a coronary angiography would be necessary (if cardiac enzymes result positive, this is the next step to be followed). You should discuss with your doctor on the above issues. Hope to have been helpful! Feel free to ask any other questions, whenever you need! Greetings! Dr. Iliri