Cardiac MRI necessary for stable angina assessment?
Hello doctor,
I am a 70-year-old male. I am under treatment for stable angina for the past three years. 80 % small artery blockage, and 50 % large in certain areas. I am taking Clopidogrel, Nitrates, Amlodipine, etc., with tiny sublingual Nitro, averaged 25 Nitro pills over three months. Occasional episodes of twinges occur, but then they remit. I feel there is a need for cardiac MRI to gain a current picture or status of my disease. I feel occasional chest tightness and dull pain but I also have acid reflux disease. What could it be?
17 May 2024 - 1 min read
Why does my heart rate significantly vary during rest and exertion?
Hello doctor,
I have no previous history of heart issues. I am 28 years old, and for the last seven days, my heart rate has been sporadically up and down within seconds. When I am resting, it is in the low 80's or even 70 beats per minute. The minute I move, it can jump to 90 or 100 beats per minute. Anytime I get up and do anything, it goes to a high 100 to 120 beats per minute. It is hard to take a deep breath. My oxygen level is low when monitored during sleep, and it has become difficult to get sleep. At times, I spit up white sputum, and my urine has turned yellow despite drinking water and not taking any medication. I have been fasting for two days and have not been hungry whatsoever. I tested negative for COVID-19 and influenza, and my EKG (electrocardiogram) seemed fine. My chest feels hit every time I cough. I have been burping a little lately and have had two headaches in seven days. My blood pressure is the same as it has been for a while. I figured it would improve within seven days, but has worsened in the last three days. I know my body well and have never had these issues. It is similar to altitude sickness, but it has not gone away. My main concern is when I breathe, it hurts my throat or chest.
Please help.
Thank you.
16 May 2024 - 1 min read
What medication can help control my mother's blood pressure?
Hello doctor,
My 94-year-old mother has hypertension and is under therapy for blood pressure. She has been visiting her cardiologist regularly and has taken therapy for years. She is otherwise in good condition. Before two months, however, her blood pressure started to fluctuate in the mornings. She had lower or normal pressure, so she omitted morning therapy. We visited her cardiologist, and they corrected my mother's therapy accordingly. I have attached the cardiologist's full report for your interpretation.
Now comes the problem: A week ago, a couple of weeks after visiting a cardiologist, my mother had unstable blood pressure with peaks up to 200 mmHg systolic. She is highly distressed both day and night. We have to frequently change therapy, even with a two-hour time difference between two successive drugs, to drop the pressure.
My mother is now afraid to sleep because of unpredictable blood pressure. She will get exhausted soon. Do you know how to stabilize blood pressure and establish regularity in therapy?
Please help.
16 May 2024 - 1 min read
Do statins and healthy habits reduce lipoprotein levels?
Hello doctor,
I am a 44-year-old female, 5.2 feet tall, and weighs 147 pounds. There is a family history of heart disease; my grandfather died of a heart attack at 41, and my father had heart disease in his 40s, ultimately passing away from a heart attack at 72. One week ago, I discovered that my lipoprotein (a) level is 278.4. Despite maintaining a reasonably healthy vegetarian diet for the past five years, I have consistently had high cholesterol throughout my adult life. I am now considering reintroducing occasional meat in my diet due to a perceived lack of certain nutrients. Although my doctor previously advised against statins, citing a low risk (calculated at 0.5 percent based on factors such as good a1c, low blood pressure, non-smoking status, and age), last week's revelation of an elevated lipoprotein (a) level (278.3 mol/L) has prompted reconsideration.
I have a new doctor, and he says I am overthinking this and did not seem to think I even need to worry about lipoprotein (a) being so high because of my low risk. I feel he is dismissive of the risk as it was low before we knew about the lipoprotein (a), but what about now? According to everything I have been reading this week, this is a serious matter, but I do know the internet can be a scary place to look for medical information. He prescribed statins anyway because I was upset and needed something to make me feel like I was lowering my risk, so I started tablet Atorvastatin 20 mg yesterday. I initially asked for PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors as I read they can lower lipoprotein (a), but he said he could not do it.
My test results show, lp(a): 278.4, Apo B: 122, total cholesterol: 235, HDL: 54, triglycerides: 124; and LDL: 159 (measured approximately four months ago). So many questions came up, and I could not get answers, so I wanted a second opinion. Is my risk as low as my doctor says, even with this high lipoprotein (a)? Can people with high lipoprotein (a) still live long healthy lives, or are we guaranteed heart disease? Will a statin that increases lipoprotein (a) increase my risk rather than reduce it? Do you agree with the course of treatment? Should I take Aspirin as a preventative measure (I read high lipoprotein (a) can cause clots)?
Please feel free to tell me if I am overthinking. It would help me sleep tonight, but I also want to know my real risks.
Thank you.
15 May 2024 - 1 min read
I feel something in the throat without pain. Why?
Hello doctor,
I have had a feeling like something had been at the back of my left side of the throat for a few days. I do not know what it is? Tonsils are not inflamed, throat a bit dry, and does not hurt to swallow.
15 May 2024 - 1 min read
