Zanax – Cardiology doctors online

Archive for December, 2009

Question: Treatment of hypertension: over 2 years old drink appointed cardiologist Concor 5mg tablets, 10mg norvask. The pressure is constantly maintained in the norm of 120/80 to 105/70. However, I noticed that the onset of summer often kept the pressure on 90/60 to 100/65. At this time, I reduce the dose to 5mg norvaska. Performance slightly increased but not significantly. Then I try 5mg norvask divided in half and then a week later I started "jumping" pressure from 98/60 to 150/90 episodes. I take off the pressure korinfarom 1tab and return to 5mg norvasku. By the way, at low pressure, I do not feel any discomfort, but with increasing concern to 140/90, and from this it has LARGE increases. Furthermore, addition to the winter period there is instability of pressure, and I have to increase the dose of 10mg norvaska and with this rule before the summer period, mostly stable. The real question: whether to strive to improve the performance of pressure, if it falls below the established norm in the above scheme of treatment?

Answer: It was so nice to read your question because you are very responsible attitude to treatment. Focus on your state of health at a low blood pressure – if the head strength and weakness in the body – to reduce the dosage, if all goes well, it does not tend to increase pressure, as will his race. Incidentally, Concor to 2.5 did not try to reduce (if not more than 75 pulse alone)? You can try to maintain 10 norvaska.

Question: Doctor! I'm 48 years old. I extrasystole on the basis of aetiology. Pulse from 50 to 65 strokes, but it happens less frequently. Prescribed 1 tablet betalok sion (25) and 2 tablets kordaron (200). And how can you? Pulse-it will be quite low! And in general, whether the disease is dangerous? Best regards.

Answer: this beats you feel it? If yes, then take Inderal 10 mg of the situation – if you feel pronounced heartbeat. If you diagnosed according to ECG arrhythmia, then live in peace. Such pulse betalok I would not advise you to drink. Why kordaron appointed? His in atrial fibrillation more often than prescribed. Thyroid hormones were examined? Some questions. Write his full medical history, I'm not a psychic, to the two proposals to give you a full consultation.

Question: The child is 8 years old. Ventricular ekstrosistoliya, group extrasystoles 19000 per day, mostly at rest and at night. Organic disorders were found in the heart, thyroid gland in the order, a neurologist – also normal. The child has fatigue, shortness of breath, "pricks" in the heart. What do we do? Cardiologist appointed hawthorn drink, and come in 2 months.

Answer: Potassium, magnesium, calcium, looked at the child? Extrasystoles too much, we must look for the cause. I advise you to apply to a large children's cardiac clinic may even have to make special studies to identify the source of arrhythmias.

Question: I am 52 years old. Almost 17 years when I was given EKG – partial blockade of right bundle branch block, with this defect, I even passed a medical commission in flying school. This year, during the passage of the commission of Seafarers in the ECG have written complete blockade, and rejected. In March, I did ultrasound of the heart, while examining any comments on the work of the heart was not. I feel good. In principle, not limited by physical exertion (of course within reason). Also, when the last recorded ECG, EKG that carry the load is prohibited. Please, explain to actually complete blockade so dangerous, or doctors are reinsured, and if any restrictions. What you can give advice. Sincerely, Valery.

Answer: It's good that you feel well. Doctors, of course, to a greater extent reinsured, but strictly speaking, they are right: the progression of partial to full blockade may be indicative of a developing pathology of the heart. If you are a smoker, then this is the first step towards the development of chronic pulmonary heart, we must think about this. The sample load in the blockade of right bundle branch block is not dangerous, and impractical, because it allows us to estimate changes in the final part of ventricular complex on ECG under load, ie, to diagnose coronary artery disease. Councils can give only a general nature, not seeing you: do not smoke, drink no more than 20 ml of alcohol in terms of pure alcohol per day (if more – then the inevitable early death), eat less and move more. Trite, but it is much cheaper and more effective than a long, costly and of little help treating the consequences of heart attacks and strokes.

Question: dear Doctor! I am 60 years old. In December 2007, making biochemical analysis of blood. Results of the analysis (lipid fraction): cholesterol – 5.02, HDL-1, 2; LDL – 3.16; VLDL-0, 66; atherogenic index-3, 18; triglyceride-1, 45. Results of the analysis in August 2009 as follows: cholesterol – 4.52, HDL-0, 88; LDL – 1.69; VLDL-1, 95; atherogenic index-4, 14; triglyceride-4, 28. Most of the indicators in 2009 does not match the norm. What?

Answer: Dear Victor, on the last analysis is similar to type IV dyslipidemia (high triglycerides), which has a moderate risk of atherogenicity. It should be treated. First of all, a diet low in cholesterol, daily exercise at least 30 minutes of brisk walking, taking the omega 3 (dose you should tell the physician in full-time admission), be sure to lose weight (if overweight). Diet: eliminate or minimize the ingestion of products that are rich in cholesterol: fatty meats and poultry (besides white poultry meat and lean beef), sausage, sausages, ham, butter (you can – vegetable oil), eggs of birds (you can eat no more than 1 egg per week), whole milk, cream, sour cream, fat cheese and cottage cheese (you can – low-fat milk, cheese and cottage cheese). To consume a lot of foods rich in fiber, bran (2 tablespoons a day). If after 3 months the lipid profile did not improve, it is possible for medical therapy.

Question: my son 1year 2mesyatsa, he has Down syndrome, only recently he was diagnosed with heart disease, cardio-consultation took place, we scheduled an operation. My question is: Is it possible at this age to do such operations, and what the probability of recovery? And why this urgency?

Answer: With some heart defects surgery should be done at an early age (Depending on the size of the defect). If you do not do the surgery in time, the disease goes too far (irreversibly increases pressure in the pulmonary artery). Children carry these operations sometimes even better than adults. In some (small) DMZHP may intravascular defect closure okklyuderom.

Question: Our son, 1 year 10 months, a month ago he was diagnosed with the UPU, atrial septal defect, NC – 0. The size of atrial septal defect 9,7 mm – 8,4 mm, a weak increase in the right departments. Diagnosis is based on a survey of VSD № 1, Saint-Petersburg (doctor Tsytko) – St. Petersburg is considered one of the best doctors – diagnostician. He told us that at the moment a child in treatment does not require, at his health is not yet affected, to come for a visit after six months. In addition, the doctor said that the operation in any case have to do, since the age of 16 the child has to start health problems due to atrial septal defect. He advised to eliminate okklyuderom atrial septal defect, but not now, but somewhere in 3 – 3,5. In any case, we want to operate only at your center in Berlin. Let me ask you a few questions of interest to us: 1. Why wait until the child turns 3 – 3,5 years, why not conduct an operation now, because despite the fact that he is at present no clinical manifestations of the UPU, but there is a slight increase of right heart due to atrial septal defect? 2 . What are the advantages and disadvantages of eliminating atrial septal defect okklyuderom. Among the doctors themselves, there are many conflicting views on this issue. In particular, LA Bokeria believes that install small children okklyuder dangerous because the heart of the child to be active growth and how to behave in some foreign metal object in the heart is not known. After all, what happens to these children in the long term – while no data no? 3. What kind of operation in our case, advise you: using okklyudera or all of the same strip. After a surgery in a child more likely to be completely healthy person without any restrictions? I heard that people with okklyuderom rest of his life can not be a cell phone near the heart to wear and to avoid contact with microwave ovens? Very forward to your reply. Sincerely, Svetlana.

Answer: 1 and 2: atrial septal defect can watch until the child grows. If you put okklyuder now, with the growth of the heart – it can shift and defect re-emerge. In centers dealing with this problem by using okklyuderov (Amplazer) developed treatment algorithms for almost any clinical situation (an international certification of specialists). So the main thing – not where (Berlin, or Moscow), and who (as closing procedures conducted in person your doctor). 3. Okklyuder – from the wire, so if you do not climb internal microwave oven,:) nothing to fear, but probably not get a CT scan chest. If you can close okklyuderom, why would "cut" (long anesthesia, cardiac arrest, heart-lung bypass…)

Question: I'm on Holter revealed rare politopnye Jay (93.) Sinus arrhythmia and incomplete blockade of the SA 2 degrees. This is dangerous, and could die from this?

Answer: No, not die from this, but you counter fatigue. Of all the listed interest is the only SA-blockade, repeat ECG (Holter not) through the year, but until then live in peace.

Question: Dear Doctor! I am 32 years old, had just arrived from the sanatorium, where did ECG and RRI. It turned out that I have a strong sinus tachycardia. Pulse 124 beats per minute at rest, RRI: the predominance of the sympathetic division of the autonomic nervous system, the path of realization of the central incentive – the nerve, expressed stress adaptation and adaptive mechanisms. Nevertheless, the doctor said that everything is normal, that "such" people live happily ever after and advised to drink motherwort and valerian. Prior to that, the heart is not worried, only occasionally ache a little and pulled the last time did a cardiogram at the institute 10 years ago, when seemingly everything was normal. Reading the previous questions, I saw that people drink blockers at lower rates tachycardia! What do I do? Is there cause for concern?

Answer: Yes, 124 alone – too much. I advise you to Holter monitoring, to pass tests for TSH and T4 (thyroid function), consult your cardiologist or physician.

Question: Hypertension in man. Accepts monopril 20 mg and indapamide 2.5 mg. Recently, gout tortured. In the summary of monopril have information – side effect – the gout. Tell me please, what should monopril?

Answer: First of all – you are sure that it is gout? Diagnosis confirmed rheumatologist? A typical attack of pain in the metatarsophalangeal joint with redness and increased temperature, increased uric acid in the blood (though not necessarily, but still). Or is it a traumatic arthrosis?. If, indeed, gout, then yes, there are among the side effects of ACE inhibitors gout. There is a kinship of drugs – angiotensin receptor blockers such as valsartan, Irbesartan, they have no gout in side effects. It makes sense to try to replace monopril. The specific dose and name of the drug – a physician with full-time appointment. Incidentally, if we speak of gout, then indapamide, which belongs to thiazide derivatives, are more likely to cause increased levels of uric acid in the blood.