Based on my father's reports, kindly suggest remedies for his suffocation and tiredness.

Question

Hi doctor,

My father has some breathing problems for the last few days. He is breathless in the middle of the night. He is tired and has suffocated. We got an echocardiogram test and several other tests done yesterday. I am attaching the prescription and reports. We want your suggestion for the further steps.

Answer 1

Hi,

Welcome to icliniq.com.

I went through your query and have reviewed all your reports (attachments removed to protect the patient's identity).The echocardiogram is suggestive of severe left ventricular dysfunction with low ejection fraction meaning inadequate heart pumping. That is the reason for all his symptoms. First of all, we need to evaluate the causes for his left ventricular dysfunction, which most likely could be due to coronary artery disease blockages in heart vessels. I need to know some more details about his present symptoms. Did he have chest pain on exertion or at rest anytime before? Any history of heart disease or heart attack? Does he have diabetes, hypertension, a history of smoking, or alcohol intake? Has he undergone coronary angiography? If not, then get an angiography done to see for blockages. Then we need to decide on the further line of management, either with revascularization or medical management, depending on his report. Of course, there is a need to make some changes in his medicines also. But, for the time being, you can continue the treatment as advised by your doctor. Kindly get back with the above details and investigation reports for further discussion and management. Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I went through your reply. It seems that apart from age, there are no other significant risk factors. It is better to get evaluated for coronary artery disease so that if it is reversible, revascularization will be helpful for his left ventricular dysfunction. Get back with further investigation reports for further management. Thanks.

Answer 3

Hi,

Welcome back to icliniq.com.

I have gone through his angiogram report. It seems to be minor CAD (coronary artery disease). In other words, the blockage is not significant to cause severe LV (left ventricle) dysfunction. It is good to hear that there are no blockages. It is necessary to treat him with optimal medications. I can suggest some medications to be taken if you send his current list of medications taken with recent kidney function test results. I have gone through his previous reports. Please mention the condition of his symptoms now. Please mention the severity of breathlessness. Kindly get back with the above details for further management. Take care.