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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Single Vessel Disease, Gets Chest Pain Extending To Hands And Legs On Taking Medicines. What Should Be Done?

Dear Doctor, Greetings!! a month before my mother reported with chest disconformt which she went for ECG which was not normal further doctor asked to go for TMT which again reported positive. Per these reports they asked to go for angiography . from that she diagonosed as below ----- Coronal Angiographic profile - left main -- Normal. Left ant. desc. --- Normal. Diagonal-1 --- mid 40-50% plaquing. Left circumflex -- proximal mild plaquing RCA -- dominant vessel. Proximal plaquing and mid 90% stenosis . Final impression --- single vessel disease. They suggested to go for PTCA and STen to RCA. Further we took openion of very senior cardilogst where he said this can be well recovered by medicine. below are the medicine she is taking - Morning – Rancad 500mg (ranolazine) flavedon 20 sorbitrate 10 mg (1/2 table) nitrocontin 2.6 amifru 40 corflo 5 -norcorandil Afternoon - flavedon 20 sorbitrate 10 mg (1/2 table) Evening - Rancad 500mg (ranolazine) flavedon 20 sorbitrate 10 mg (1/2 table) nitrocontin 2.6 corflo 5 –norcorandil these medicines he asked to take for 1.5 mths before further checkup. Whenever she take these dose she report pain in chest with pain in left hand from mid to middle finger .....but from last couple of days she said she feel pain when she sir folder her legs for toilet. Sir I would be highly thankful to you...if you please help me with your valuable advice to get her well soon as we all in tension on what to do next.. also she is not ready for angioplasty so looking for your help to know wht can be done for her to get well soon. from a month now she is eating almond day to improve good colestrol...with full control on diet.
Tue, 11 Jun 2013
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Cardiologist 's  Response
Dear patient,

Thanks for your health concerns. It is reasonable to manage obstructive chronic coronary artery disease with medications, but not all the time we can take away symptoms completely; it seems that many of the medications she is taking could use an increased dose at the discretion of your senior cardiologist (I recommend talking to him to see if some can be increased) to try to control symptoms; if after 1.5 months of being on maximal medical therapy she is still having chest pain symptoms, then an angioplasty would give her better chances of making her pain free.

Yours truly,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
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Single Vessel Disease, Gets Chest Pain Extending To Hands And Legs On Taking Medicines. What Should Be Done?

Dear patient, Thanks for your health concerns. It is reasonable to manage obstructive chronic coronary artery disease with medications, but not all the time we can take away symptoms completely; it seems that many of the medications she is taking could use an increased dose at the discretion of your senior cardiologist (I recommend talking to him to see if some can be increased) to try to control symptoms; if after 1.5 months of being on maximal medical therapy she is still having chest pain symptoms, then an angioplasty would give her better chances of making her pain free. Yours truly, Dr Brenes-Salazar MD Cardiology Mayo Clinic MN