Brief Answer:
Some measures regarding lifestyle; eventual changes in medication

Detailed Answer:
Hello and thank you for your question. I understand your concerns. Welcome to HCM.

I will try to be as thorough as I can, and take your questions step by step.

1 - about the echo cardiogram report. It is almost inherent to find a mild left ventricular diastolic dysfunction in also every human being. Also, trace mitral and tricuspid regurgitation is a reflection of a very small amount of blood being returned through these valves during systole. However, these are not findings to be worried about. Since these grades of the regurgation take four or five decades to produce symptoms. I recommend you not to be worried about as this is a normal echo cardiogram, with normal ventricular function and motility.

2 - the blood pressure figures are a very fluctuating parameter of the human organism and it can be raised even in physiological situations such as psychological stress, physical activity, alcohol, tobacco etc. However, if you had been my patient I would prescribe propranolol to you, instead of concor cor. In the context of weaning it off, I would recommend you to halve the dosage of what you are currently taking, for one week, and then discontinue it altogether. I think that afterwards it should suffice that you kept diary about your blood pressure figures.

3 - About the medication - the liver medication is effective and safe, so I think you should continue them. We discussed about the concor cor. Being younger than 45 years of age, I really would recommend you to also discontinue aspirin and rosuvastatin. Your BMI is 33, and I think simple lifestyle changes would help you to lose weight and the parameters would go back to normal. As I may recall, I have addressed one of your issues about three months ago (hopefully I am not wrong), and then I remember I have offered you a detailed regime how to lose weight.

4 - No relation of one certain area ache and use of aspirin or rosuvastatin whatsoever. It is indeed known that rosuvastation may cause liver damage in 8% of cases, but no physical signs of it, only functional, which is not your case, because, as I can see from your reports, your AST and ALT levels are normal.

5 - No relation between rosuvastatin and diabetes. They may be co-found in metabolic syndromes, or dyslipidemia may contribute to diabetes and vice-versa.

6 - Your heart is totally fine, and the stress test you have conducted say so, so I would recommend you to explore any physical activity you want to do and not withhold it in any moment. Also, it is advised a 60-minute physical activity, of any kind, a day, as a healthy way of living the life.

About the seventh point, I think we discussed in the other points. The major factor in your case is that you are 35 years of age. All the cardiac and blood tests are normal, except cholesterol which can be brought to normal with weight loss, without need of medication. Plus, last but not least, your high density cholesterol is 67 mg/dL (the "good", protective cholesterol), which is on your plus side.

I thought I was helpful and thorough with my answer. I am happy to help, if you have follow-up questions.

Best regards,
Dr. Meriton

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Brief Answer:
Not at this moment

Detailed Answer:
Hi again and welcome back.

You are welcome, I am glad I was able to help.

Since you are young and you have now stable blood pressure, I would recommend you not to start propranolol at once, but rather monitor you blood pressure for a few weeks and, if needed, then we can get you started on low-dose propranolol.

I hope my follow-up is helpful.

Best regards,
Dr. Meriton

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