Dr. Vivek S Narayan Pillai
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
Hi doctor,
My father had a heart attack three weeks ago. Now, he is under medication and in complete rest at home. But echocardiogram report says his LVEF rate is 29 %. Some cardiac enzymes are high. How can we improve the rate of LVEF? Can this percentage get improved by rest or diet or something? His blood pressure, cholesterol, and sugar levels are normal. There are no blood clots present. He feels tired if he walks at home even more than 15 minutes.
Hi,
Welcome to icliniq.com.
Your father had a heart attack and from his echocardiography report, (attachment removed to protect patient identity) the affected areas are thinned out and akinetic. It means that the heart muscles have lost their function in these areas. He can take drugs like beta blockers, ACE inhibitors (Carvedilol and Ramipril) to improve the cardiac function. What are the medicines given? The other method is to assess if there are any other blocks present in the coronary arteries and get removed either by CABG (coronary artery bypass graft surgery) or angioplasty. But I would suggest first do a myocardial viability study to see if the thinned out akinetic areas have any living muscle present to improve his cardiac function.
Patient's Query
Thank you doctor,
The doctor has prescribed the following medicines such as Angiplat 2.5 mg, Rosufit CV 10 mg, Nikoran 5 mg, Panlipase 10000 capsules, Pan MPS suspension 200 ml, Stresnil 0.25 mg. Are these enough? Blood report says there are no blood clots present. Can the percentage of LVEF get improved?
Hi,
Welcome back to icliniq.com.
He needs to take tablet Carvedilol 3.125 mg three times a day. The dose can be adjusted depending upon the blood pressure and pulse rate. Take Tablet Ramipril 1.25 mg one tablet a day depending upon the blood pressure and the serum creatinine level. There is an option of CRT (cardiac resynchronization therapy),that is putting, a pacemaker leads in the three chambers of his heart. But, this is done after seeing his full ECG (electrocardiogram) reports and if he is fully optimized with his cardiac drugs. However, CRT may improve LV function (left ventricular function) when the ejection fraction is 60 to 70 percent and ideally, he needs an angiogram to assess the coronary arteries.
Patient's Query
Hi doctor,
He is little better now and is complete rest in home . We are allowing him very little to walk inside home. Doctor told after three months, he will undergo another echocardiogram and he will compare new report to old report. I hope he will get better soon. Thank you
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Cardiology
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