Brief Answer:
I would suggest some key points.

Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your husband complains (headaches and nausea), they are nonspecific findings of several pathologies; so it is difficult to differentiate at the first contact. At the beginning, an ischemic cardiac etiology should be excluded. Sometimes cardiac ischemia appears with headache instead of chest pain. A careful cardiological follow up is required to rule out this component. After assuring for an alternative cause, I would recommend some key points to look for.
(1) First we have to look after the blood pressure; a transient abnormal high BP value may be associated with nausea and headache. BP monitoring must be performed frequently during the complains. Ambulatory 24 hours BP monitoring could be helpful to discriminate high BP values. Could you tell me more about this issue and other medical history related to the symptoms?
(2) We have to check for any possible drug side effects. There are antianginal drugs, such as nitrates that may cause headache and unpleasant feeling in certain patients. Could you send the list of prescribed medications your husband is taking for his heart problems?
(3) What about neurological domain? Did your husband discuss his complains with a neurologist? As several neurological conditions may be associated with headache and nausea. Tensive type of cefalea is a common cause of headache in patients suffering from heart problems or any chronic medical conditions. Migraine, some atypical trigeminal neuralgia, or even some forms of epilepsy may give rise to this clinical scenario too. I recommend to visit a neurologist for a full history interview and a careful physical examination to elucidate the nature of headache.
If you send me additional data of his medical history, current treatment and performed exams I could give a more specific advice.
Hope to have been helpful to you! Greetings! Dr. Iliri

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Brief Answer:
I recommend a few tasks for you.

Detailed Answer:
Hello again! I passed through your husband medical history and prescribed treatment. Seems that things are getting a little messy. What is my advice??

(1) Symptoms like headache, nausea and flushing suggest as I have mentioned you before uncontrolled high blood pressure. Please rule out high BP during symptoms onset by close monitoring.
(2) Severe breathlessness is really a big problem and should be clarified, as it causes restrictions in daily activity and triggers depression. First, I would like to know his cardiac function status. His prior medical history has past through a heart attack, so it is important to know if heart failure (as a possible complication of heart attack) is responsible for dyspnea. A cardiac ultrasound and a NT-pro BNP (blood test) would help to rule out heart failure.
(3) As I mentioned any possible drug side effects regarding present symptoms should be ruled out. Drugs like Duloxetine, Cetirizine, Allopurinol may exert some unwanted effects like headache, nausea, dizziness. Chronic use of Cocodamol may be responsible for what is called drug-induced headache. A careful investigation should be performed on this issue to discriminate any possible culprit member. Talk with his doctor, about an opinion for any possible reduction of therapy.
(4) I would recommend again a visit to the neurologist, as I am sure he would be the best coach for guiding the differential diagnosis of headache.
So, to conclude, and cut it short and clear for you, I would recommend: BP control; cardiac ultrasound coupled with NT-pro BNP test; discuss possible side drug effects with your doctor; consult a neurologist.

Hope to have been helpful. My Best Wishes! Dr. Iliri

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Brief Answer:
Unfavorable habits should be avoided.

Detailed Answer:
Hello! Considering your husband condition I would highly recommend to minimize as much as possible taking this quantity of daily drinks. Taking these drinks complicates further medical reasoning, regarding drugs interaction and aggravating side effects. A screening of liver function should be made. Please talk to his doctor about this issue. It is important to let him know the unfavorable habits of your husband.
Hope to have been helpful to you!
Best Regards! Dr. Iliri

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Brief Answer:
Everything counts inside the body.

Detailed Answer:
Hi! I know it is a bit difficult to deal with. But after heart attack the drug gallery has increased and excessive drinks do influence for sure on their pharmacology.
This is an important point of discussion with his doctor. Don't forget it! Greetings!

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