82 years old lady is having swelling of foot with bluish discoloration. Is it due to blockage of blood vessel?

Hello,

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Her foot appears to be in good condition now (attachment removed to protect patient identity). The likely cause for bluish discoloration is blockages only and is called peripheral arterial disease. So of she should be treated on the line of blockages itself. Now blockages in the foot raise the strong possibility of blockages elsewhere in the body like heart, brain, and its fortunate that she did not suffer any consequences due to that. So she should be evaluated with few investigations, like ECG (echocardiogram), Echo, Fasting lipid profile (sugar if not done recently). Also, to confirm the diagnosis, she should undergo CT (computed tomography) angiography of both the lower limbs. Now coming to the treatment part, obviously, the best would be to open it with stents. But as of now, she will need some more medications than what she is having. You may continue with Neurowin or better to have it in a tablet form once daily, and it is just a multivitamin supplement. She should also continue plain Ecospirin and dose should be 75 mg only at bedtime. Now in my opinion, she should additionally have tablet Rosuvastatin 10 mg bedtime once daily and tablet Cilostazol 50 mg twice daily after food. She should also have some antacids along with these medications like tablet Cyra 20 mg (Rabeprazole) once daily before breakfast. So these three medications should be added additionally until her evaluation is completed and probably will need to continue for the long term. Zerodol SP should be avoided as it may harm her by causing bleeding or raising blood pressure. Plain paracetamol is allowed. She should be encouraged to move and walk atleast 30 minutes a day as it would improve blood flow. I hope this helps.

Hello, Her lipid profile is deranged and thyroid is mildly elevated. Rest reports are fine. So besides healthy lifestyle, she would need a medications for lipid profile. As I mentioned last time, tab Rosuvastatin should be added and it will take atleast 6-8 weeks to control her lipid levels. For thyroid, she should be started on tab Eltroxin 12.5 ug once daily before breakfast at 6.30 am. There should be gap of 45min to 1 hour between thyroid and acidity medication cyra. Repeat lipid profile and thyroid level after 8 weeks. All the best.