Hello,

Thanks for posting your query.


I am happy that you have undergone these tests. 70% blockage definitely requires treatment with the drugs that you have mentioned. Any form of additional effort in the form of exercise, garlic, meditation, etc will only add to the benefit.

PLEASE DO NOT STOP THESE MEDICATIONS WITHOUT CONSULTING YOUR DOCTOR

The drugs you have been prescribed are life saving.
1. It prevents heart attacks (clopivas)
2. Helps maintain a healthy heart (miraqule)
3. Helps reduce/prevent chest pain (cardivon)

You will also have to continue your blood pressure medications as high blood pressure will cause injury to the
1. Heart
2. Kidney
3. Brain
4. Eyes
This damage cannot be rectified once done.
Please re check with your doctor regarding blood pressure medicines on your next visit.

You are also overweight as your BMI is 27.4. You will need to reduce 8 kilos to come to a normal weight BMI. I would suggest that you eat a light, nutritious and balanced diet and exercise under the supervision of your physician.

The most important of treatment in these conditions is compliance with the treatment. Drugs don’t work when taken irregularly. So it is important that you continue taking the prescribed medications. If you experience any side effects of the said therapy, please consult your treating physician who can advise you on the same.

I hope I have answered your query. Please accept my answer if there are no follow up queries

I wish you good health

Regards.

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Hello.

Thanks for the reply.

I have gone through the reports in detail. You doctors have done a good job in investigating your current problem.
They have decided to put you on a non invasive management right now as the myocardium (the muscles of the heart) is receiving adequate blood supply and more so because your faired well on the TMT.

Stent is only put when the TMT shows ischemic changes on exercise or you have certain issues like chest pain on trivial work, etc. But, in the future there are chances they might opt to put a stent.
The major indications for stent placement are:

1. Post bypass graft failure.
2. Stent re stenosis.
3. Ostial disease.
4. Chronic total occlusion of an arteries.
5. Active myocardial infarction (heart attack).
6. TMT showing ischemic changes.

Now to answer your queries one by one

1. Shortage of blood supply is only due to blockage of the arteries because of cholesterol deposits. These cholesterol deposits will occur in normal people without hypercholesteremia too with age. Smoking is also a major contributing factor for blockage of the arteries.

2. Blockage can only be reversed by stenting or bypass grafting with surgery. Medically a blockage is managed by
i. Slowing down the cholesterol deposition.
ii. Increasing the blood flow by dilating the arteries.
iii. Making the blood thinner hence increasing the flow.

3. I think you mean EECP, this unconventional method is used for only those patients who still have angina (chest pain) even after stenting is done. This mode of therapy is not applicable to you right now. It will only give you symptomatic relief when you are having chest pain, it will not reverse the pathology. In other words it will not reverse the blockage.

4. I have already listed out when the angiogram+angioplasty is advised.
Your current EF is normal. EF above 55% is considered normal. It will change fast if you get a heart attack, otherwise EF will remain stable.

I hope, I have answered your query, please accept my answer if you have no further queries.

I wish you good health.

Regards.

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Hi,

Thanks for reverting.

1. Belching will not aggravate your angina, but eating heavy meals will. So avoid over eating.

2. Yes, you are suffering from chronic stable angina. You can increase your exercise tolerance slowly by
i. Sticking to your medications, i.e. taking them regularly
ii. Talk to your physician about the kind of activity you can safely do and what you should be specifically avoiding. I should warn you that you should not be overzealous and should always stop when you get chest pain.

3. Vitamin E will neither solve nor reduce the problem. It is indicated more in blockage of arteries of the leg. Even otherwise, there is hardly any evidence that it is of any benefit. Please do not use Vitamin E as a substitute for any of your medications

4. Cherries, apples, papaya, grapes and pomegranate are good for the heart. You can have one portion daily.

5. On your next visit to the doctor, please ask him about the following things

i. If you can travel

ii. What do you do when you get chest pain on exertion, if a prescription of sub lingual nitroglycerine is necessary in your case. This drug will bring down the angina immediately

iii. Whether you need anti-hypertensive medications called ACE inhibitors or Angiotensin receptor blockers (ARBs)which has proved to be cardio protective

iv. When should be visit him next and how often the visits should be? You should also ask him to enlighten you about the danger signs and when it is necessary to come for a visit immediately and not wait for the next appointment


I hope I have answered your query. I am happy you are taking keen interest in your health.
If you want to contact me specifically, then from next time you should start your query with 'dear doctor Rakesh madhyastha' the query will come to me. You can also write a review about me if you like.

Please accept my answer if there are no further queries.

I wish you good health

Regards

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