Patient's Query
Hello doctor,
My mother occasionally experiences chest pain that lasts for one minute but can sometimes occur for up to half an hour. There is no jaw pain, pain radiating to the left hand, or vomiting associated with it. Is this incident serious, or is it common for heart patients? Her weight is 209 pounds. The doctor initially prescribed her Nebivolol 5 mg, but another doctor has since reduced the dosage to 2 mg. Her blood pressure is currently 106/65 mmHg, which is on the lower side. In a previous report, the doctor also referred to Atorvastatin and vitamin supplements. Additionally, her cholesterol levels are low. What should I do?
Please provide guidance regarding her medication.
Hello,
Welcome to icliniq.com.
I have reviewed the echocardiogram which shows normal LV systolic function, and LV diastolic dysfunction, and it appears to be fine. You mentioned that she is a heart patient. Has she suffered a heart attack in the past or had any other indications of heart disease? I believe she may just have a blood pressure problem but no heart disease at present. The type of pain you are describing does not seem to be angina pectoris and is likely not related to the heart. It may be associated with gastritis or reflux disease. Additionally, muscular pain is also a possibility.
Does she experience upper abdominal pain, nausea, bloating, burping, increased pain after eating, a sour taste in her throat, or chest burning? These symptoms could be related. If she has any of these symptoms, it raises the possibility of gastritis, and she should be prescribed the combination tablet of Pantoprazole and Domperidone once a day before breakfast for two weeks.
Have you had her ECG (electrocardiography) done? If so, is it normal? It would be beneficial to perform a treadmill test as part of routine screening in older patients. If she is unable to do that, she could have a stress thallium test or a CT (computed tomography) coronary angiography. While these tests are not absolutely necessary, they can help detect any underlying minor issues if they exist.
Next, if Nebivolol is prescribed solely for blood pressure management, then the reading you mentioned is low and may require a dose reduction. I recommend purchasing an electronic blood pressure monitor to frequently check her BP at home. Regarding Atorvastatin, you can reduce the dose to 10 mg once a day at bedtime if her cholesterol levels are well controlled. It is advisable to continue this medication as it offers multiple benefits beyond just cholesterol management. Folic Acid, vitamin B6, and mecobalamin, which are multivitamins often prescribed if neuropathy is present, such as tingling or numbness. Is she diabetic?
Regards.
Patient's Query
Hello doctor,
Thank you for the prompt reply.
She is not diabetic. Yes, she does complain of acidity. My father passed away, and shortly after that, she began experiencing shortness of breath and random chest pain. She was hospitalized, and the doctor provided her with a treatment discharge card. Two-dimensional echocardiography and a treadmill test were performed. She completed a 10-minute treadmill test despite her obesity. During the stress test, she became very anxious, and the report came back positive. The doctor mentioned that she had not fully completed the stress test but gave her the benefit of the doubt and prescribed medication. A two-dimensional echocardiography test was also conducted. During her six-month follow-up visit, the doctor advised her to continue the medication. Over the course of a year, she occasionally experienced mild chest pain. Given this history, is it necessary for her to undergo a CT coronary angiography?
Please advise.
Hello,
Welcome back to icliniq.com.
The pain is likely due to acidity. However, her treadmill test (TMT) was positive. She should undergo angiography; if you are not mentally prepared for that, at least consider a CT coronary angiography to confirm the situation. She should also be on blood thinners, such as Aspirin 150 mg, in addition to Atorvastatin. Please consult with her specialist doctor, discuss the options with them, and take any medications with their consent.
I hope this helps you.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byDr. K. Shobana
Same symptoms don't mean you have the same problem. Consult a doctor now!
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