Dr. Muhammad Zohaib Siddiq
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a female with a height of 5.4 feet and 112 lbs weight. I have had a complete blood count test every year since I had an episode of heart palpitations some years ago. I had a CT angiogram done ten years back, which showed disease in the left anterior descending to a maximum of 50 %, and everything else was normal. I was put on Atorvastatin as my cholesterol levels were raised. My cholesterol level is fine now.
Over the years, my MCV (mean corpuscular volume) has been creeping up. Yearly, the MCV value has been 103, 113.5, and 117.3 for the past four years, and now it is 103. Then, the RBC count was 4.03, 3.71, 3.93, and now it is 3.75. I did start taking low-dose aspirin ten years ago but stopped as it was causing stomach problems. They also offered me Clopidogrel, but when I read the leaflet, it showed that the tablet can cause strokes? Is that correct? Should I take tablets for thinning blood? I have a family history of strokes and heart attacks.
I am on Atorvastatin 20 mg. Currently, I feel more sluggish and a feeling of less blood circulation in my legs and feet while walking. However, when I raise my legs, they feel normal.
Kindly advise.
Hello,
Welcome to icliniq.com.
I suggest you take tablet Aspirin 75 mg daily (enteric coated) and tablet Atorvastatin 20 mg daily as your LAD (left anterior descending) artery is 50 % blocked. These medicines prevent further blockage. MCV (mean corpuscular volume) is not an issue if you do not have symptoms of feet numbness and tingling. If you are a vegetarian or your vitamin B12 levels are low, I recommend taking vitamin B12 and folic acid supplements. Also, I want to know whether you have hypertension or diabetes?
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I have a slight tingling sensation in both my feet and lower legs which is more like numbness, especially when I wake up. I lift my legs into the air for a minute, and the sensation returns to normal. I did not realize that taking tablet Aspirin 75 mg daily would further stop the blockage due to LAD. My vitamin B12 and folic acid levels have been tested, and they are within limits. Also, I do not have diabetes or hypertension.
Kindly advise.
Hello,
Welcome back to icliniq.com.
It is good to know that your vitamin B12 and folic acid levels are normal. Aspirin 75mg enteric coated tablets inhibit platelet function and prevent blood from clotting inside the narrowed artery, thereby reducing the risk of disease progression. Also, tablet Atorvastatin 20 mg should be taken as it lowers LDL (low-density lipoprotein) levels, as LDL cholesterol increases the risk of narrowing arteries in the heart. I suggest you do moderate-intensity aerobic exercises like brisk walking that increase the blood flow to the legs and feet, thereby decreasing the numbness.
I hope this helps.
Thank you.
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Cardiology
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