Hi doctor,
My query belongs to my mother. She is 73 years old. She is not overweight. Few days back, suddenly she felt heavy headache and after few minutes had pain in her throat. We immediately checked her BP and it was high at 180. So, she had BP medicine and after half an hour she felt normal. Now I have done a test profile and attached it for your reference. Please advise us if there is any heart related issue.
Hi,
Welcome to icliniq.com.
I want to assure you do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and reports (attachment removed to protect patient identity) and can well understand your genuine health concerns. Her serum amylase levels are a bit high than the normal limit (according to the specific lab range for normal from where she got tested). In such a case some tests are extended to see what may be the reason behind this. Is she a known hypertensive/diabetic/thyroid disease and taking any medicine for that? Her apolipoprotein B (Apo-B) levels are a bit high. Does she have any heart disease and taking any medicines for that? It is necessary to see if she has a serious risk factor associated due to heart disease or diabetes that may lead to some risk for her. Hs-CRP levels (high-sensitivity C-reactive protein) are increased in patients having coronary artery disease. It may be high in other issues too but we have to rule out the cardiac disease first. Homocysteine is not a significant marker as to show coronary artery disease of the heart but definitely her cardiac evaluation is needed. It also increases with age.
The probable cause is coronary artery atherosclerosis but needs clinical correlation through physical examination and the following testing.
Investigations to be done:Do fasting blood sugar levels HBA1c, LFTs (liver function tests) and RFTs (renal function tests), fasting lipid profile, ECG (electrocardiogram), exercise tolerance test, angiography and echocardiography.
Treatment plan:Her cardiologist may advise after careful monitoring and diagnostic tests. Make an appointment as soon as possible with her cardiologist.
Preventive measures:Ask her to take nutritious food like green leafy vegetables and fruits like kiwi, avocado, banana and orange. Almonds and nuts are also good. Give her Citrucel (Methylcellulose) dietary fiber supplement for good digestion and to control cholesterolTake two to three liters of water daily.
Regarding follow up:Revert back with the investigation reports to a cardiologist.
Hi doctor,
She is not suffering with any condition such as diabetes, hypertension or thyroid. Her fasting blood glucose is normal. The reports of HbA1c, fasting lipid, LFT and RFT are attached already. Please check and advice her some medication to take before physical examination. Is it fine to go and meet her cardiologist in four to five days?
Hi,
Welcome back to icliniq.com.
Thanks for providing the details. I have once again worked through your mother's case.
She has some factors in laboratory work that are indicative of high risk for heart diseases. Every marker and test used for heart health evaluation is somewhat indicative of higher cardiac risk. But this is not an issue that may have developed today. It has developed in years. Her cardiac evaluation is necessary but it is not an urgent emergency. You may go for that as you mentioned after four to five days.
Investigations to be done:The tests I had already seen. I meant to say that her cardiologist will need the following tests to evaluate her.
Treatment plan:Her cardiologist may advise after careful monitoring and diagnostic tests. Make an appointment as soon as possible with her cardiologist.
Regarding follow up:For further information consult a cardiologist online.
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