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Treatment For Mild Ischemia. What Is The Difference Between Mild Ischemia And Inducible Ischemia?

Posted on Fri, 23 Nov 2012

Question: related to ED and love life

i am 38 years old and recently gone for health checkup. every test are normal. total cholstrol -212, ldl-131, tmt - time 13 min, 14 mets full tolerence. no pain, no difficulty, , no history of heart pain, but results shows mild ischemia, pl guide me,how to proceed furthe, any non invasive analysis, any drugs needed. no history of parents heart attach. 1.ECG is nornal. all blood tests are normal except LDL 131 and Chol: 212
2. In TMT, result is mentioned as positive for inducible ischemia, and Echo results are normal. I completed the full mets without any difficulty. What is the significance of inducible ischemia? What is the difference between mild ischemia and inducible ischemia?.

2.cardiologist advised me to change the life style, food habbits, excercise. also prescribed a. razel 10 mg b. coversyl 2 mg daily for six months.

3.
5. whether i can use treadmill and can do normal activities, continue sex

6.
7. I learn that there may be side effects of coversyl, it may create ED, In that case, What is the alternate, Can use sildenafil for improving love life. pl guide me

Answered by Dr. G.Srinivasan (1 hour later)

Hi,

Welcome to XXXXXXX and thanks for your query.

I will confine myself to the questions related to ED and sex issues. Other issues are best addressed by a cardiologist ( like ischemia etc) as i am not a competent person in this issue.
Normally, in cardiac patients, exercise is advisable to the point of tolerance. This answers your tread mill question.

I would approach the ED this way.

1. If there is trouble initiating and maintaining an erection, it is worthwhile changing coversyl to another medicine right away.
2. If there is no trouble getting an erection, try GENTLE sex without exerting too much and STOP IMMEDIATELY if shortness of breath or chest pain occurs. This is extremely important.
3. If there is erectile problem,sildenafil can be started WITH THE CONSENT OF THE CARDIOLOGIST. It is extremely important NOT to take NITRATE/NITRITE along with sildenafil ( for example ismo/isordil/nitrocontin).

Hope this answers your query. Kindly get back for doubts if any,

Wising you good cardiac and sexual health---

Regards
DR GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (18 hours later)

Respected doctor
Really happy to receive your mail.
Previous year 2011 health checkups were normal including TMT except LDL(131). Recently two weeks before only I have gone for Mater health checkup and normal ECG and all the parameters are normal except LDL(131). So my doctor advised me to continue Coversyl 2 mg and rosuvastatin 10mg for another six months for cholesterol and mild inducible ischemia problems. Also he informed me coversyl is good for reducing blocks if any.As I mentined I have no symptoms of chest discomfort and even normal BP.
Based on the advise I started these drugs last week 25.10.2012.
But for the ;last one year I experienced ED problem occasssionally, I also occasionally used sildenafil, it works well [since I am 38 years old and my love life also important]
My concern is, at this stage Can I use Sildenafil along with Coversyl and Rosuvastatin or separately for my love life [Since I am worried about my love life]. What is the recommended dose?. Is it safe if I do not strain much? what is the alternate sir
What is the permanent diagnosis/ remedy for ED.
Kindly guide me for my healthy and happy life sir.

Answered by Dr. G.Srinivasan (2 hours later)

Hi,

Welcome back.
Sildenafil should not be taken with nitrites, otherwise it can be taken with your other medicines.
Gentle sex with or without Sildenafil is ok.
ED is due to disease of the blood vessels of the penis - like the heart ( coronary vascular disease) and erection enhancing drugs need to be taken when necessary.

Wishing you good health---
Regards
Dr GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (1 hour later)

Respected doctor
thanks for your valuable information
Which dose I can use for sildenafil?
Whether coversyl contains nitrate
Really I feel comfirt after ur information sir
thanks for your moral and mental support

Answered by Dr. G.Srinivasan (55 minutes later)

Hi,

Welcome back. Coversyl is a ACE inhibitor. It IS NOT a nitrite.
The reason for mentioning nitrite is that most heart patients take nitrite at some point. So even if not today, you need speak to the doctor that any medicine added is not a nitrate.
Having said that if nitrate is considered essential by your doc, then sildenafil needs to be stopped.
The usual dose is ten mg whenever necessary, to start with.
Kindly discuss this issue with your urologist before starting.

Wishing you good health.

Regards
DR GS

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar