Patient's Query
Hello doctor,
I am a 44-year-old male, and I had a heart attack. I underwent angioplasty and was diagnosed with a 100 % block on the coronary artery, and I had one stent placed. Since then, I have been on a continuous check routine. Currently, over the past three months, medicines have been reduced as my condition is under control, as insisted by my cardiologist. Otherwise, post-angioplasty, following a good diet and exercise routine, quitting alcohol, and smoking.
Yesterday night, I had stomach discomfort as I had eaten outside food. Later, it had formed gas or bloating and eventually a little pain on the left back side, below the waist, and below where the left arm joins the shoulder. I started checking my blood pressure; it was high 165/95 mm Hg, and my pulse was 63 beats per minute. I panicked and could not sleep, and kept monitoring my blood pressure. Meanwhile, I passed motion two or three times in the morning today, and my blood pressure came to normal, 128/75 mm Hg, and pulse 65 beats per minute. This evening I took an ECG and attached the same. Could you please access and tell me everything is normal?
Thanks.
Hello,
Welcome to icliniq.com.
I can understand your concern.
The problem you have described does not appear to be cardiac in origin. It is understandable to experience high blood pressure when your body is uncomfortable, such as during acidity, bloating, nausea, vomiting, or loose motions. However, if loose motions are severe and continuous, your blood pressure could eventually drop due to dehydration. If your condition has improved and your blood pressure is normal now, there is nothing to worry about. If you are still experiencing loose motions, chest pain, or back pain, I recommend consulting a physician in person.
It would have been helpful if you had shared your previous ECG (electrocardiogram) for comparison. Nonetheless, the ECG you provided does not show any acute ST elevation. It indicates a normal sinus rhythm with an adequate heart rate and no block. I suggest you keep an eye on your blood pressure and, if necessary, consult a cardiologist in person. As you have a history of heart attacks and stenting, please keep taking your heart medication on time regularly.
I hope this information will be helpful to you.
Thanks.
Patient's Query
Hello doctor,
Thank you for your response.Actually, my BP and the pain in my back have returned to normal since yesterday morning. BP was 124/75 mm Hg, pulse 65. But, yesterday night I started again getting pain below my left shoulder blade like the day before. I thought it was repeating, but after some two hours, the pain moved to the center of my back and was there till early morning, kind of intermittent.
BP again went up to 175/100 mm Hg, but the pulse was 68. I could not sleep due to panic, though, as per my medicine routine, I had taken Ecosprin Gold AV 75/40 (Aspirin 75, Clopidogrel 75, and Atorvastatin 40) after dinner.So, today morning I went to a local cardiologist as my treating cardiologist is 120 km away in the city. He also took an ECG and said it's normal and only shows spikes of my previous heart attack. So, he has prescribed a blood test called Quantitative (Troponin-I-I) and C-Reactive protein. I received the report, but the cardiologist will come back only on the eve after 7 pm. I have attached the reports. Could you please access and advise?P.S.: I also had uncontrolled diabetes before my heart attack. Also smoked and drank alcohol for 6 years until last year. But post that, as per my cardiologist's advice, I switched from insulin injection to tablets Gibtuliomet 12.5/500 in mor and Istamet 5/500 at night.
So, post my heart attack, my diabetes was in control with average HBA1c = 5.8 to 6.. Also quit smoking/alcohol and I maintain a good diet with fiber-rich foods, nuts, fruits, vegetables, limit oil and use only ground nut and olive oil, moderate in our cooking.
Please help.
Thank you.
Hello.
Welcome back to iCliniq.com.
I hope you are feeling better now. Your blood reports are within normal range, and that is very reassuring. I am very happy that you are on a heart-healthy diet. Please continue to have a healthy lifestyle and take your medication on time.
I wish you good health.
Take good care of yourself.
Regards
Patient's Query
Hello doctor,
Thank you for your reply.
After that, I followed up with my local cardiologist. He also said all the reports are normal. When I told him I still get the pain on my lower back left side intermittently radiating towards the left lower abdomen, he told me to use any spray type pain relief and see for another two to three days for the pain to go. If it still persists, then he has been asked to go to a gastroenterologist.
Now, past two days, every evening post 7 pm, it gradually starts from the lower left back, and at times it radiates to the lower left abdomen below the ribcage. Sometimes, the feeling is like it is gas. As I already have intermittent constipation (not severe), my bowel movements look close to normal or unusual.
So, I have decided to see how it prevails for the next two days and then go to a gastroenterologist. Meanwhile, if the pain elevates, can I take a Cyclopam tablet or a Paracetamol tablet only for the pain? Since I take cardiovascular medicines like Aspirin, Clopidogrel, can I take Cyclopam?
Please help.
Thank you.
Hello,
Welcome back to iCliniq.com.
Thank you for writing back.
I hope you are feeling better now. I wish you a healthy life. It is a good idea to consult a gastroenterologist for your pain. They can examine you in person and advise medication for quick relief. You can always take Paracetamol and Cyclopam for symptomatic relief. Both are safe medications and do not interfere with your cardiac medications.
You can also try over-the-counter antacids for better results; meanwhile, plan to meet your gastroenterologist. Please continue with a heart-healthy as well as a stomach-friendly diet. Avoid oily and spicy food for a quick recovery.
I would also suggest visiting your doctor soon if the pain is severe and does not alleviate with your medications. Please let me know if you need anything else. I wish you a fast recovery.
Regards.
Patient's Query
Hello doctor,
Thank you for your reply.
Finally, I got an appointment with a gastroenterologist for tomorrow.
Could you please once suggest whether I can take Cyclopam tonight for the pain? Because they are stating that Cyclopam (Dicyclomine) should be used with caution in patients with coronary heart disease or cardiovascular problems. If you suggest it is no problem, I would take it for tonight; otherwise, please suggest any over-the-counter antacids.
Thank you.
Hello,
Welcome back to iCliniq.com.
It is good to know that you have finally got an appointment with a gastroenterologist.
If you have previously used Cyclopama and had no problems with that, then you can take it for tonight as well. Also, if your blood pressure or heart rate is stable, then its ok to take Cyclopam.
If needed, any over-the-counter antacids that are magnesium-based or aluminium-based based such as Mucaine syrup or syrup such as Sucralfate, can be used for now.
Please take good care of yourself, and let me know if you need to know anything else.
I am always here to help you.
I hope this helps.
Thank you.
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Answered byDr. Wajahat
Medically reviewed byiCliniq medical review team
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