Zanax – Cardiology doctors online

Archive for November, 2009

Question: Good day! 10. 07. 09 I had a heart attack. Agree Concor 5 mg, omakor, kardiomagnil 150 mg, preduktal-MB 2 x 35 mg, 10 mg tulip. Periodically, I hand over a blood test. Growing bilirubin total: 8. 09. 09 – 23,8; 19. 10. 09 – 26,3. Bilirubin direct – 3,2 and 4,5. ALT and AST were normal. The doctor said a month not to take tulip, then re-check the bilirubin. Seems tulip planting the liver. If you do not take tulip, what is the probability of formation of plaques in the vessels of the heart and the recurrence of a heart attack?

Answer: Dear Victor, a sign of toxic liver injury is not increased bilirubin and increased AST and ALT. You are normal, so to speak of "planting liver wrongfully. Statins should be taken, it prolongs life. When you receive a statin is considered normal AST and ALT levels increased up to 2 rules. Believe me, in the food we eat every day, much more "chemistry" than in the statin pill.

Question: I'm 40. With 24 years of age suffer sympathoadrenal crisis, 30 ill SLE and APS, accept metipred 7 years. In February it was rising blood pressure 160/100 and lasts for 5 hours. The ECG signs of left ventricular hypertrophy, the X-ray revealed enlargement of the heart to the left, on hormones gained extra weight – about 50 kg for 7 years. Last month, the pressure rises in the day, several times, he is accompanied by a state of panic, my hands were shaking, I can not lie, all as in the sympathoadrenal crises, but only the pulse of 60 and motherwort not help. 4 years ago, a cardiologist ordered Concor 2,5 mg drink now, it was easier to endure crises and pressure during crises was 160, not 180 as it was. Recently, her husband called an ambulance, I removed the pressure kapotenom, now drink the blood pressure rises as the bonnet, the doctor can not get a general practitioner record, but I have no time to sit in the queues. Show you I have hypertension? Maybe I do not need a therapist?

Answer: Natalia, you have examined your cardiologist, to ascertain the cause sympathoadrenal crises. It should also be borne in mind that metipred can also raise blood pressure. Discuss with your Rheumatologist vozmozhnot addition to the treatment of SLE an alternative drug to reduce the dose metipreda.

Question: Good day! Operated for stenosis of 2 arteries in February 2009. Performed CABG surgery. Condition generally normal, but often oppressive nature of pain in the shoulder. After the massage shoulder pain immediately goes away, but some time later reappears. This year, resting in a sanatorium in Kislovodsk. This pain was almost constant. Took narzan baths. ECG did not deteriorate. By Holter without drugs pose coronary artery disease and angina of 1 degree. Shortness of breath no. Pressure is now only in the morning – from 130/70 to 157/90, afternoon and evening – the norm. Agree Concor 5 mg, amlodipine 5 mg, aspirin-Cardio 100 mg, Crestor 5 mg. I love skiing and this year in December we will be leaving for Switzerland. How do you think this is my benefit or harm? I am 56 years old, weight is normal.

Answer: Margaret, I would be in your place in the mountainous areas has not left yet. Specific air, variations in atmospheric pressure may increase the frequency of angina attacks you.

Question: What medication can replace retarpen me these injections done in spring and autumn to prevent rheumatism. Dosage: 1 injection * 2.4 million in 30 days, 3 times.

Answer: Dear Tom, non-proprietary name retarpena – benzathine benzylpenicillin. He also issued under the name ekstentsillin, moldamin (both have dosage 2.4 million). I do not know, unfortunately, under whatever name the drug is released you have in Tallinn, so if a pharmacist does not find these drugs, then name him nonproprietary name, he light upon the appropriate medication.

Question: 6 years ago I had an operation for prosthetic mitral valve prosthesis LIKS-28, MIX-21 aortic and tricuspid plasty. Can I make a flu shot A/N1N1? I am 57 years old. Last 46 years I did not do any vaccinations after acquired rheumatic defects in 11 years. Is there any information about the immunization-designed after surgery to prosthesis? How do they tolerate such patients? I am afraid, valves "cleave" bacteria from grafted flu, but this flu, too afraid. So do or not do, that's the question? Sincerely, Lyudmila.

Answer: Dear Lyudmila, bacteria from vaccination nowhere cleave for the simple reason that they are not in the vaccine. If you currently do not have any colds, it is better to be grafted.

Question: Hello. I am 25 years old. In 23 of the year was increased pressure. Diagnosed hypertension. At the same time put a different diagnosis – diencephalic syndrome with frequent simpotoadrenalovymi crises (shaking hands, dizziness, occurred panic and fear of death). The reason neither the one nor the other is not named. For three years I drink metoprolol, told to drink for life. Every six months, dig salts. Tell me please, do so will be all my life? Or you can find the cause of disease and cure? Do the hypertension and diencephalic syndrome?

Answer: Dear Anastasia, you are describing symptoms may be a sign of secondary hypertension, you will need examined by a cardiologist, to pass a special urine and blood. In such a young age are not uncommon avoidable causes increase in blood pressure.

Question: I am 54 years old. Three or four years ago, I asked the cardiologist complaining of shortness of breath sometimes appears, but a local cardiologist after the test told me that quite well (although a few previously stated that I did not like the tenant). Six months later, during the examination on another occasion I was raised – to analyze ECG (including repeated ECG) – the diagnosis "myocardial infarction" (though I did not complain of the heart) – and was almost forcibly hospitalized. After treatment (almost a month) in the hospital two weeks later, I was again sent to the hospital with the same diagnosis after analysis of ECG on admission cardiologist (have another). After the hospital I was sent to a sanatorium for rehabilitation. Then conducted further tests. It is now two years after that, I feel much the same as before. When there is loads of shortness of breath, which I learned to fix with the help of breathing (nitroglycerin preparations did not take). Of the medicine is taken only preduktal (from all the others refused). Now, recalling his association with other patients, describe their feelings, as well as analyzing all available information, I have a question: Was there a heart attack? And if this heart attack? ECG always clearly shows – a heart attack (this, local doctors say, and the hospital, and in the regional cardiology, and even in Bakuleva so to speak). But at the same time: – I have never experienced pain in the heart as other patients – the pressure I always like an astronaut (80… 120, maximum 140); – cholesterol – in normal conditions (the ratio of HDL and low density – better than the optimal) – cardiography showed that vessels from me – net (at least, there is no need to stenting). After becoming acquainted with all indicators of confidence in my doctors myocardial dropped sharply, thinking for a long time, but in the end – do not say anything new, but simply prescribe a course of treatment (I was already thinking in a bit, and I understand that treatment – it was a heart attack). Only the district doctor once casually dropped (said to herself), that probably is not no heart attack. In his medical records, I found a record of the survey by ultrasound that my heart has a tumor in the wall of the left ventricle, and it creates a hydraulic resistance 12. . . 14 mm Hg. column. Maybe that is the case? Even I have some problems with the liver (but not cirrhosis and hepatitis), or somewhere close to it (sometimes I feel the bitterness in the mouth). Actually, the entire myocardium saga began in the survey process of the liver, has not ended. After the meal, shortness of breath increases significantly, but in a hungry state feel good, and the ability to overcome the load increases significantly. Question – can, indeed a heart attack as such and was not? The problem – in the heart, but it is not associated with blood vessels? And should be treated accordingly? Last time I began to feel some pain in the chest area (as with some of angina, but outside of the sternum), but go to the doctor, I fear – suddenly again hospitalized for a month, then I will just end because of the inability to work ( it would have been more justified, this hospital). Show you can have any special methods of examination, or special. honey. organizations involved in these surveys to more clearly, or more specifically define what I do. Or'll show options, what could it be.

Answer: Dear Alex! Regarding infarction. Up to 20% of heart attacks – silent, painless, so no wonder. And the pressure is not necessarily to 0 falls on them. Diagnosis of heart attack is on 3 pillars – Clinic + troponin + ECG (cardiac enzymes). If 2 of these indicators is pathologically altered, then a heart attack is quite probable. Doctors then found your ECG changes related heart attack and act accordingly. Coronary angiography does not always give an accurate result, especially in relatively young (for a heart attack) age as you. You can be so-called "soft" plaque without stenosis by coronary angiography in and you can not see. This limitation of the method itself, rather than the experience of physicians. Again – all of the above – my reasoning on the basis of your story, not confirmed by objective research results, inspection. As to the "tumor" in the heart and the hydraulic resistance – for me it is just words. We need to do echocardiography, everything will be clear. There is a tumor – it is necessary to consult with heart surgeons, no tumors – forget about it once and for all. Must doobsledovat gall bladder, liver (ultrasound + biochemistry AST, ALT, GGTP, bilirubin). Sometimes, rarely, sometimes so-called cardiac form of cholecystitis, which may even appear atypical changes in the ECG. But this is an extremely rare situation. Holter ECG did not hurt – we should see if there is ischaemia during the day. And another problem you have. It is the distrust of doctors. You prescribe – you do not drink them because they doubt the existence of myocardial said, as I understood, even in bakulevskom Institute – you still are not sure. It is your right, I understand you and have no right to judge, but agree that it is very difficult to advise, knowing that the patient still will not listen and will be in doubt. And now you are afraid to see a doctor because they can be hospitalized. Dear Alex, in our free country forcibly hospitalized only the mentally ill, a threat to society, and then by a court decision. In this category you are absolutely not. You can always write a rejection of hospitalization, it is your right to insist on hospitalization, according to current law, doctors are not eligible. So I still advise you to consult your doctor, start with a general practitioner and neurologist. If still not satisfied, then a specialized cardiology center, to solve all your doubts. And without trust in the doctors did not work, is of no significance. Good luck and health!

Question: Zravstvuyte. I am 75 years old. For the last week in the second half of the day or night, the pressure rises from 120-135 to 160-180, and it is difficult to reduce. Advice. Every day, take the morning 0,25 Concor, evening 1 tablet amlodipine, 0,10 simgala. Just sick flu, took antigripoznye drugs. Krahmaleva Karina.

Answer: Dear Karina, you have too small a morning dose of the drug against the pressure. Contact your therapist, it will help her skorrigirovat.

Question: Heart attack of myocardium, followed by two procedures of coronary angiography performed in the clinic of Tartu University. In vessels fitted 8 stents (5 and 3), designated drugs for home treatment: heart aspirin, Plavix 75mgx1, Betaloc ZOC 100mgx1, Torvacard 20mgx1, Norvasc 5mgx1, L-Tyroxini 100mgx1, Imdur 30mgx1. Prior myocardial had thyroid problems and hypertension, 2 nd degree. After being discharged from the hospital about a week in the mornings (between 10 and 12 hours) began to emerge weakness, the pressure decreases, pulse with peryvami. At the time of the visit to the family doctor cardiogram was normal. What? Maybe some drugs should be deleted or reduce their dosage. Referral to a cardiologist from the family doctor has not received as at that time was not on this basis. .

Answer: Dear Valentine, doses seem to be adequate, but if I were your doctor, I would have tried a little to reduce the dose of beta-blocker. But this is only speculative arguments on the internet I do not have the right to change your treatment. Insist on the direction of a cardiologist to correct treatment, in the end it is your health that you have only one.

Question: dear doctors! Please, help with any survey other than ECG, general tests and should undergo echocardiography. I am 58 years old, last month plagued compressive pain behind the sternum, placed under the left shoulder blade, while blood pressure may vary upwards. Doctors diagnose new-onset coronary heart disease, angina pectoris. The pains occur, as in the rest state, and the mild walking. Am on bedrest. When receiving nitroglycerin pain pass. Seizures occur, their frequency per week every other day. The very high blood pressure, blood pressure rises 160/200 obese.

Answer: Sergei, the most complete answer to the question that you have and what to do, will only coronary angiography. When it can immediately be said, if you need surgery, which really prolong life. If still not able to hold her, then at least test with physical load or daily ECG monitoring to document the ischemic changes. All risk factors for coronary artery disease you have there, so that the diagnosis is really likely. It should be treated! Nitroglycerin – is not a cure, e is only a short-term assistance. There are other medications that the doctor prescribes after classroom hours.