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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Medication For Chest Pain And Body Weakness

I am very overweight. 20 st I am 67. I am type 2 diabetic. I have high blood pressure controlled by medication. I am in permanent AF. I have Hashimotos disease.I had been caring for my husband for the last three years, he was suffering from renal cancer which had spread to his spleen,liver,lungs and bones. He died in August and his funeral was on 18th Sept.On the 23rd Sept I had crushing pains in my chest which was relived by a spray under my tongue. The next day I had an angiogram and suffered a TIA. I recovered overnight and the CT scan showed my brain to be unremarkable.The consultant stopped my Flecanide which I had been on for 8 years. He started me on clopigrel, 75mg candistartin 75mg and atorv astartin 80mg. I do not feel very well, I was phyisically strong before this first episode and am now having chest pain when I attempt even the smallest household job, it is relieved with rest and GTN spay. The other problem I have recently is losing strength in the thigh muscles and my arms. Do you consider that I need to take 80mg of statin and do all these tablets have any contra indications
Fri, 1 Jul 2016
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General & Family Physician,  's  Response
Hi there.
Your symptoms seem to be a combination of Diabetes complications and Ischemic Heart Disease.
While your Chest discomfort/pain with even slightest of activitiy and relief by GTN spray is highly suggestive of Ischemic Heart disease and needs urgent consult with a Cardiologist.
Increasing the dose of statin(atorvastatin) will not help with the existing load of disease. You need anti-heart failure medicines like Diuretics and meds to aid contraction of your heart and possibly an intervention in the form of a Coronary angiography.
Your muscle weakness is suggestive of a diabetes related complication. Diabetes over the long run causes atrophy of major girdle muscle groups in your body like around the shoulder and around the hip along with other muscle involvements also which leads to weakness and tiredness and easy fatigability.
So my suggestions are -
1)Check your blood sugars including 3 month average(HbA1C) and make sure its under control. Insulin is beneficial for both sugar control and with cardiac disease
2)check blood pressure and reduce salt intake to reduce load on your heart
3) cardiologist review along with an ECHO to look at the cardiac status and decide about the further meds.
Hopefully this helps.
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Suggest Medication For Chest Pain And Body Weakness

Hi there. Your symptoms seem to be a combination of Diabetes complications and Ischemic Heart Disease. While your Chest discomfort/pain with even slightest of activitiy and relief by GTN spray is highly suggestive of Ischemic Heart disease and needs urgent consult with a Cardiologist. Increasing the dose of statin(atorvastatin) will not help with the existing load of disease. You need anti-heart failure medicines like Diuretics and meds to aid contraction of your heart and possibly an intervention in the form of a Coronary angiography. Your muscle weakness is suggestive of a diabetes related complication. Diabetes over the long run causes atrophy of major girdle muscle groups in your body like around the shoulder and around the hip along with other muscle involvements also which leads to weakness and tiredness and easy fatigability. So my suggestions are - 1)Check your blood sugars including 3 month average(HbA1C) and make sure its under control. Insulin is beneficial for both sugar control and with cardiac disease 2)check blood pressure and reduce salt intake to reduce load on your heart 3) cardiologist review along with an ECHO to look at the cardiac status and decide about the further meds. Hopefully this helps.