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What Does This Following Blood Report Indicate?

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Posted on Tue, 17 Jan 2017
Question: I have undergone stents 2.5 years back . On medication now
Consivas 40 and Prax A

Pfa , my routine check report for your perusal

Kindly advice
doctor
Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
Most of the reports are good.

Detailed Answer:
Hi XXXXXXX
Firstly thanks for choosing health care magic for asking your query,

Have gone through all your reports ,
Most of them are perfectly normal.

Infact LDL cholestrol is 68 mg/dl , Post PTCA target LDL is less then 70mg/dl, so lipids are very well controlled.

Your TSH is elevated , you are hypothyroid , should ask your physician or cardiologist to start thyroxine in low doses 12.5mg initially which could be increased gradually over time( please note - thyroxine tablets have to be taken empty stomach at 6 am with a sip of water and nothing should be taken for next two hours, most of the doctors will not mention this ;but this can severely hamper the effectiveness of the medicine).

Your vitamin d levels are significantly low XXXXXXX tayo k 60k should be taken once in a week for 4 week and once in a month for 4 month , to replish the levels of vitamin D.

Your vitamin B12 levels are also quiet low , Tab supradyn should be taken once a day for 3 months, it will take 3 months time to replish the deprived levels .

Lipoprotein A are marginally high , they are basically predictors of coronary artery disease in future .There is no medicine to decrease them(however antioxidants can lower their levels) , they are regulated by our genes ,But as lipids are normal ;slight elevation in Lipoprotein A is not that significant.

Apart from that all other reports are normal, you can ask your cardiologist to shift you from Prax to Clopigrel as long term bleeding complications with clopigrel are far less as compared to prasugrel,(in case you want to read trials comparing Prasugrel with Clopigrel you can mail me on my email id , i will mail you the trial papers).

You are on only two medicines Consivas 40(statin) and Prax A , i don't know why you are not taking a beta blocker and Ace inhibitor , they are always indicated post PTCA ,as they prevent cardiac remodelling and are cardioprotective.

In case you have any other query or want any other details, i would be happy to help you!

Thanks
Dr Rishu Saxena,
Cardiologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rishu Saxena (29 minutes later)
Thanks Dr for detailed explaination. I stoped taking Met XL 25 mg , 1.5 months back . Do you recommend i should start taking it again. What could be the possible reason for TSH increase is it due to medication? Can i control it with diet change. Why lipoprotien are high if cholestrols are fine?
doctor
Answered by Dr. Rishu Saxena (31 minutes later)
Brief Answer:
Details below!

Detailed Answer:
Hi
I don't know why your cardiologist stopped metoprolol , but according to me if there is no contraindication in your case then beta blocker should be taken once daily.A recommendation to start can be made only after knowing the cause of stopping beta blocker; you have not mentioned why your doctor stopped beta blocker.

TSH increase means that your thyroid is not functioning properly, a reason to it is very difficult to give ; hypothyroidism can be because of number of reasons, in your case the medicines you are taking have nothing to do with thyroid gland, don't worry hypothyroidism is very common these days an can easily be managed by medications.

No you can't control it with diet, thyroxine has to be taken orally.

Lipoproteins have nothing to do with cholestrol, lipoprotein is a predictor of cardiac risk while cholestrol deposits in arteries and causes cad.Both of them are totally different, Level of Lipo depends on your genetics ,and it can't be altered.

Advice
start a beta blocker
ace inhibitor low dose
Switch from prasugrel to clopigrel.

thanks,
Dr Rishu Saxena
Cardiologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rishu Saxena (14 minutes later)
It was my misatke to stop it . I was feeling little anxious after taking it. I will start taking it again. I am recently shifted to Ahemdad looking for cardilogiest . I wish if you can recommed someone in Ahemdabad It will be great. Thanks
doctor
Answered by Dr. Rishu Saxena (7 minutes later)
Brief Answer:
See details

Detailed Answer:
Hi
I am in XXXXXXX , Have no idea about Ahemdabad ,sorry .
You can mail me your discharge slip, your 2 d echo reports and Angioplasty reports.
You can follow the medications prescribed by me , as treatment is standard for Angioplasty patients.I need to see your angioplasty papers, before prescribing the doses.You can follow up with your local cardiologist after that once a year.
If you feel a bit anxious after taking betablocker then a low doses anti anxiety med can be added, but betablocker is a must!
Echo and TMT should be done every year to see the patency of the stents!

Thanks,
Dr Rishu Saxena
Cardiologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rishu Saxena (1 hour later)
I got my CT and 2D done . As per my XXXXXXX Dr everthing is fone stent postion are perfect. It is drug eluted stents.reports attached for tour reference. I habe been doing regular checkup
doctor
Answered by Dr. Rishu Saxena (9 minutes later)
Brief Answer:
Mail it!

Detailed Answer:
Hi
I can't see any report, if you're having problems attaching , mail them directly to my id or contact the Customer care for further assistance.

Awaiting


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rishu Saxena (1 hour later)
I dont have your email id. If you can share,i will do the needfull
doctor
Answered by Dr. Rishu Saxena (1 minute later)
Brief Answer:
follow-up

Detailed Answer:
Hi,
YYYY@YYYY

Thanks
Dr Rishu Saxena
Cardiologist XXXXXXX XXXXXXX
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Rishu Saxena (41 hours later)
Hi Dr, I have mailed my complete medical history teat performed post PTCA and other realted detailsnin breif PDF doc for tour perusal.
doctor
Answered by Dr. Rishu Saxena (3 minutes later)
Brief Answer:
Ok,will review them.

Detailed Answer:
Ok !
Have a safe and fast recovery !

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

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
Dr.
Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Does This Following Blood Report Indicate?

Brief Answer: Most of the reports are good. Detailed Answer: Hi XXXXXXX Firstly thanks for choosing health care magic for asking your query, Have gone through all your reports , Most of them are perfectly normal. Infact LDL cholestrol is 68 mg/dl , Post PTCA target LDL is less then 70mg/dl, so lipids are very well controlled. Your TSH is elevated , you are hypothyroid , should ask your physician or cardiologist to start thyroxine in low doses 12.5mg initially which could be increased gradually over time( please note - thyroxine tablets have to be taken empty stomach at 6 am with a sip of water and nothing should be taken for next two hours, most of the doctors will not mention this ;but this can severely hamper the effectiveness of the medicine). Your vitamin d levels are significantly low XXXXXXX tayo k 60k should be taken once in a week for 4 week and once in a month for 4 month , to replish the levels of vitamin D. Your vitamin B12 levels are also quiet low , Tab supradyn should be taken once a day for 3 months, it will take 3 months time to replish the deprived levels . Lipoprotein A are marginally high , they are basically predictors of coronary artery disease in future .There is no medicine to decrease them(however antioxidants can lower their levels) , they are regulated by our genes ,But as lipids are normal ;slight elevation in Lipoprotein A is not that significant. Apart from that all other reports are normal, you can ask your cardiologist to shift you from Prax to Clopigrel as long term bleeding complications with clopigrel are far less as compared to prasugrel,(in case you want to read trials comparing Prasugrel with Clopigrel you can mail me on my email id , i will mail you the trial papers). You are on only two medicines Consivas 40(statin) and Prax A , i don't know why you are not taking a beta blocker and Ace inhibitor , they are always indicated post PTCA ,as they prevent cardiac remodelling and are cardioprotective. In case you have any other query or want any other details, i would be happy to help you! Thanks Dr Rishu Saxena, Cardiologist