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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Treatment Should Be Taken By A Diabetic For Congestive Heart Failure With Asthma And Copd ?

my doctor told me that my heart is damaged on the bottom back of my heart...no fixable. He said i am on the verge of having a heart attack , i am a 41 year old female, who is also diabetic,i have congestive heart failure with asthma and copd . I use to weigh over 550 lbs, but i have lost about 127 lbs since nov of last year. What do i do now?
Thu, 2 Feb 2012
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Cardiologist 's  Response
hi and welcome .i would like to give you a detailed answer provided you give me and additional info if you have. damaged bottom back of heart , do you have an echo or angiographic evidence .... was your attending doctor a cardiologist.... also important is that despite your risk factors for heart attack... diabetes, over weight, and probably you will have high blood pressure and abnormal cholesterols also...NOW THERE IS ADIFFERENCE BETWEEN COPD AND ASTHMA. copd is not reversible and asthma is. since how long you have this problem. this actually affects your right side of the heart where the disbetes and obesity mainly affects your left side by blocking its major arteries. thus congestive heart failure means that your left side is affected and that in turn has affected your right side of heart also. ...YOU MUST DO AN ECHO TO SEE YOUR EJECTION FRACTION AND WALL MOTION ABNORMALITIES BEFORE I CAN COMMENT IN DETAIL. well regarding treatment options for CCF in diabetic and asthma/copd patients the main stay is strict diabetic control....less levels of cholesterols even below normal ( as you are diabetic) regular limited exercise , reduction of salt intake and use of vegetables.... if sugars are not controlled by tablets then switching to INSULIN is ideal, use of regular asprin 75mg, cholesterol lowering drugs , ACE INHIBITORS only if your kidney function allows, use of diuretics and beta blockers( if asthmatic beta blockers are to be used with extreme care ...newer class called NEBIVILOL 5mg should be used , as they claim its safe in asthmatics)...if your EJECTION FRACTION IS LESS THAN 35% THEN USE OF DIGOXIN AND IF PREVIOUS HEART ATTACK CAUSED SO MUCH COMPROMISE OF LEFT VENTRICULAR FUNCTION THAT ECHO SHOWS CLOT IN IT THEN EITHER DOUBLE ANTI PLATELETS,,ASPRIN/CLOPIDOGREL OR IDEALLY WARFARIN( INR TEST MUST BE STRICTLY MONITORED WITH IT)... THAT IS THE REASON THAT AT LEAST DOING AN ECHO WITH A SKILLED PROFESSIONAL IS MANDATORY FOR YOU ... TAKE CARE
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General Surgeon Dr. Swapnendu Sekhar Ghosh's  Response
welcome to healthcaremagic
you should consult cardiologist and get total cardiac check up and follow advice
your diabetes should should be controlled and weight reduced .you need multidisciplinary treatment.
congestive heart failure diabetes .asthma to be well controlled with medicines
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Orthopaedic Surgeon Dr. Aashish Raghu's  Response
Welcome to Healthcare Magic

Firstly, you must not stress. Try to relax and be cool. You need to have salt restricted diet, also some water restriction as advised by your Cardiologist. Keep your blood sugar under control by eating more of fibre rich fruits and vegetables. Eat balanced diet with proteins, right amount of fats and carbohydrates like oats, milk, eggs, pulses, cereals. Stay away from allergens which can cause an attack of Asthma because frequently using inhaler can also rise blood sugar levels acutely. STOP SMOKING if you do or that will aggravate the heart failure. You can get Chest physiotherapy done for better lung compliance and better lung function. If capable, do mild exercise by slow walking as advised by your Cardiologist. Regarding heart attack, keep the emergency drugs near hand to abort an attack of angina. Take the medication on time without fail as Doctor advised. Take Oxygen therapy as is recommended by your Cardiologist. You can somehow arrest the progression of the disease with good habits and regular treatment and live a more fulfilling life.
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What Treatment Should Be Taken By A Diabetic For Congestive Heart Failure With Asthma And Copd ?

hi and welcome .i would like to give you a detailed answer provided you give me and additional info if you have. damaged bottom back of heart , do you have an echo or angiographic evidence .... was your attending doctor a cardiologist.... also important is that despite your risk factors for heart attack... diabetes, over weight, and probably you will have high blood pressure and abnormal cholesterols also...NOW THERE IS ADIFFERENCE BETWEEN COPD AND ASTHMA. copd is not reversible and asthma is. since how long you have this problem. this actually affects your right side of the heart where the disbetes and obesity mainly affects your left side by blocking its major arteries. thus congestive heart failure means that your left side is affected and that in turn has affected your right side of heart also. ...YOU MUST DO AN ECHO TO SEE YOUR EJECTION FRACTION AND WALL MOTION ABNORMALITIES BEFORE I CAN COMMENT IN DETAIL. well regarding treatment options for CCF in diabetic and asthma/copd patients the main stay is strict diabetic control....less levels of cholesterols even below normal ( as you are diabetic) regular limited exercise , reduction of salt intake and use of vegetables.... if sugars are not controlled by tablets then switching to INSULIN is ideal, use of regular asprin 75mg, cholesterol lowering drugs , ACE INHIBITORS only if your kidney function allows, use of diuretics and beta blockers( if asthmatic beta blockers are to be used with extreme care ...newer class called NEBIVILOL 5mg should be used , as they claim its safe in asthmatics)...if your EJECTION FRACTION IS LESS THAN 35% THEN USE OF DIGOXIN AND IF PREVIOUS HEART ATTACK CAUSED SO MUCH COMPROMISE OF LEFT VENTRICULAR FUNCTION THAT ECHO SHOWS CLOT IN IT THEN EITHER DOUBLE ANTI PLATELETS,,ASPRIN/CLOPIDOGREL OR IDEALLY WARFARIN( INR TEST MUST BE STRICTLY MONITORED WITH IT)... THAT IS THE REASON THAT AT LEAST DOING AN ECHO WITH A SKILLED PROFESSIONAL IS MANDATORY FOR YOU ... TAKE CARE