What Do These Following Lab Reports Indicate?

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

I passed carefully through your medical history and uploaded tests and would like to explain as follows:

(1) Your pulsating feeling on the bottom of your left leg palm needs to be further investigated to exclude several local factors such as a local articular inflammation, local arterial blood circulation abnormality, or local soft tissue inflammation. In this regard it is recommended a careful physical examination and if suspicions are raised about an arterial abnormality, a lower limbs vessel Doppler ultrasound is advised. The therapy would be tailored properly after the conclusion of the above clinical investigations.

(2) Based on your overall potential coronary risk factors and performed cardiac tests, the likelihood of a heart attack or sudden cardiac death is quite low. But, you need to continue treating and avoiding possible coronary risk factors in order to prevent future cardiac events (try to lower your body weight as you actually are considered obese [BMI 33.9], modify your diet to maintain a favorable blood lipid profile, engage in frequent daily physical activity, avoid close smoking contacts, etc.).

(3) The stabbing pain on your back modulated by body posture doesn't seem to be of any cardiac origin.

So, relax! It is very likely to be musculoskeletal and is probable to be caused by any backbone disc degeneration due to your increased body weight.

In such case a backbone X ray study and if necessary CT or MRI would definitely clarify this issue.

In this regard, any painkiller drugs (like naproxen, ibuprofen, etc.) would be helpful at relieving this discomfort. Nevertheless, lowering body weight would give a better and steady result, as well.

(4) Your dizziness and chest tightness during initial exertion are not cardiac related, as all your cardiac tests (including treadmill testing) have concluded normal. I would suggest another component like cervical arthrosis that may be responsible for transient blood flow disturbances and also radicular neural roots affection. Non-steroidal anti-inflammatory drugs coupled with local physiotherapy would be helpful at relieving this concern.

(5) A baby Aspirin could yield beneficial results regarding any potential inflammatory processes or pain, but doesn't seem to be necessary as a maintenance therapy as you don't have any confirmed coronary or vascular disorder.

(6) Regarding your BP values, I would explain that your referred valued 136/92 mmHg is not considered hypertension. It is within normal ranges (diastolic component at the upper limit of accepted values). Nevertheless, for concluding on BP trends it is necessary to have several BP values measured at different points during the day for at least 7 to10 days. In such way, it would be possible to calculate an average value and properly conclude on this matter.

(7) Lowering your Concor daily dose seems OK, as at your young age taking a beta-blocker (as Concor is) could decrease your overall physical performance. If a lowering BP therapy would be necessary, other alternatives should be recommended. But, this could be done only after having clear evidence that high blood pressure is persistently present.


Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Wishing you a Happy New Year!

Kind regards,

Dr. Iliri

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