I am a 55 year old male who is a borderline diabetic. I am on Metformin 500mg and on Telmisartan 20 od. I need to know the status of cardiac blocks. Will a TMT, 3D Echo and a CT Angio indicate or rule out blockages?
Leslie Fernandes
The Doctor says: A 2D Echo and a TMT would be advisable. If the TMT is positive, then a conventional coronary angiography will be required. I would not advise a CT coronary angiography.
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My mom is 55 years old. A year ago she was diagnosed with hypertension. Our physician started her on Tazloc Trio 1 od and Clopitorva 1 od. She seems fine with this medicine and her blood pressure is under control. She always asks me how long will this medication continue. Does she have to take this for the rest of her life?
Rahul Patil
The Doctor says: The anti-hypertensive indication has to be taken for the rest of her life, though the dose will generally be adjusted depending on the response. Lupiterva needs to be taken only if specific indications exist i.e. high cholesterol, block in circulation etc.
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My ECG shows T wave inversion in V3 to V6. It’s suggestive of ischaemic changes and left ventricular hypertrophy. I did this ECG merely for life insurance purposes. Kindly suggest what I should do further. I do not face any other health issues.
PP Shetye
The Doctor says: If you have no symptoms, they are likely to be benign changes. Kindly get an ECHO, TMT. Most likely that should suffice.
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I have a history of diabetes and heart ailments in the family. I smoked from age 17 to age 34. Am 36 now, slightly overweight and not very active, what do I need to do avoid having cardiac problems?
Kaustubh
The Doctor says: Appreciate that you have given up smoking, especially given the family history of DM and Hypertension. Your risk for heart disease will be down to that of a non-smoker in a few years time (generally 5-6 years).I suggest you monitor BP and blood sugar levels. Exercise regularly at least five days a week and follow a healthy diet.
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Is there a link between cholesterol and heart attack? How are blocks formed? How is it that a person with one block dies and one with three blocks survives?
Damodar K K Ghanekar
The Doctor says: Yes, heart attacks are caused by cholesterol deposition with superimposed clot in the blood circulation of the heart. Not just the quantity but quality of cholesterol is important. Block formation is a complex interplay between nature (genetics, age) and nurture (DM, HT, smoking, sedentary lifestyle and stress). How a person tolerates a block depends on various factors some of which are:
• Artery (Blood vessel)involved
• Site of block (proximal v/s gradual)
• Time frame of developing a block (sudden v/s gradual)
• Severity of block (Percentage)
• Heart pumping capacity
• Patient Co-morbidities (DM,HT)
Depending on this some patients tolerate blocks better than others. For example, gradually developing blocks are better tolerated than sudden blocks.
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How do we recognise a cardiac arrest or symptoms of a possible attack in someone and what should we do until medical help arrives?
Shruti Madkaikar
The Doctor says: Cardiac arrest is cassation of heart activity. One of the causes of cardiac arrest is heart attack. Typical symptoms are chest heaviness going to block/jaw/(left) hand associated with sweating, sense of impending doom. Silent attacks also occur. If suspected, plan to immediately shifting to a nearby hospital. Aspirin may be given if handy. If cardiac arrest occurs, give chest compression and mouth to mouth breathing.
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My mother, Maria is 78 years old. She is suffering from Ischaemic Heart Disease, Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease, Diabetes Mellitus and Hypertension.
So, what would be the right treatment for her at this stage?
Valeriano D’Souza
The Doctor says: Since she has multiple systemic involvements and advanced age. She will need a team care approach including a physician, cardiologist and nephrologist, as drugs used to adversely treat one particular systemic disease can adversely influence the other systems.
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I am 43 years old, working in automobile industry in Goa for last 20 years. For the last six to seven months my left side of chest is paining mildly, sometimes sweating a bit, pressure is normal. I checked with general physician and he told me it is due to acidity. Kindly advise what precaution need to be done to avoid such discomfort in future.
Ankush
Kindly get an ECG and a stress test (TMT) for further evaluation.
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I have had one major heart block and angiography / angioplasty done September 1 and was discharged the next day. Besides medication given, what are all dos and don’ts for me. I have been called for follow up after a month. Please advise me regarding my diet and exercise.
Vassudev Naik
The Doctor says:
1. Avoid under physical/mental stress.
2. Exercise at least half an hour per day at least five days a week.
3. Avoid deep fried foods.
4. Cut down on red meat, shell fish and prawns
5. You can have fish, chicken and egg white.
6. Suggested oils - olive, rice brain, sunflower.
7. Avoid processed and packaged foods.
8. Adequate sleep (7-8 hrs.)
9. Regular meal timings
10. Have wheat based and whole grain products.
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I am a 40 year old accountant by profession. I have a sedentary lifestyle and work 10 hours minimum a day. I had TIA three years ago and cut down on rich food. I was prescribed with ecosprin 75 mg daily. I took it for 6 months and stopped. I have extreme acidity now and when I am stressed at work, my left arm feels weak. No TIA symptoms like before. Should I continue ecosprin and are there chances of a heart attack?
Samuel Pereira, Ribandar
The Doctor says: You definitely need to continue the Ecosprin and a statin (for cholesterol) for the rest of your life, else you are at risk of developing a stroke or a heart attack. It’s good that you follow a healthy diet, but do devote at least half an hour for exercise daily.
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Recent company health tests took place and I was having plaque on my carotid artery. What is the cause of this and what do I need to do to solve this problem? Is it permanent? My GP told me it might be because of my dental problems. I had gum disease and many root canals.
Roger P
The Doctor says: No, the dental problem is not the cause for the carotid plaque. It’s because of cholesterol deposition in the blood circulation to the brain and is caused by the same factors that cause heart attacks. Whether you need to do something about it will depend on your risk factors, symptom and degree of narrowing. Do visit a neurologist for further advice.
