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Anginal pain and arrythmia - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2497 Questions

Doctor :   Hi
Doctor :  
How can I help you?
User :   How are you
Doctor :  
I am Good thanks
User :   I need heart disease information
Doctor :   Sure
User :   had first angina in ER in October
Doctor :  
You may proceed with your questions
Doctor :   Ok

User :   still have angina that is helped with nitro. plus arrythmia, plus now i have swelling in llegs and feet
Doctor :   Is it?

User :   have had angiogram. stress test. and test where they take picutres
Doctor :   Ok
User :   get weaker every day and Dr. says tests are fine
User :   Help !!!!
Doctor :   Yes

Doctor :  
I shall surely help you in finding out the cause
Doctor :  
I concern about your problem but I need to ask you many more questions
User :   fire away
Doctor :  
before I actually give you a good advice and how to go about it
Doctor :  
What is your age?
User :   50
Doctor :   Since when is the current swelling of legs
Doctor :   and feet?

User :   ~3weeks
Doctor :  
Do you have breathing difficulty
User :   occasionally
User :   with exertion
Doctor :  
How frequent?
Doctor :  
Ok
Doctor :  
How long you have to walk to catch the difficulty of breathing

Doctor :   Hi
User :   Hi
Doctor :  
Are you back?
Doctor :  
Great
Doctor :  
Let us continue
User :   thank you
Doctor :  
How long you have to walk to catch the difficulty of breathing
User :   not very far...100 feet ???
User :   have to rest after shower before getting dressed
Doctor :   Is the distance decreasing day by day?
User :   oh I'm sure it is..I feel weaker by the day
Doctor :  
Ok
Doctor :  
Did you convery the same to the doctor
User :   yes I have
User :   they just finished nuculear tests and stress tests last Tuesday
Doctor :   Were they normal
User :   "within parameters"
Doctor :  
Ok
Doctor :  
What medicines are you using right now?
User :   atenolol 50mg per day
Doctor :  
Ok
User :   lisinopril and hydrochlorothiazide 20mg per day
User :   one asprin
User :   nirotglycerin
Doctor :   Ok fine
Doctor :  
How are your Blood pressure measurements for the last couple of months?
User :   in the 170/84 range
User :   up or down depending
Doctor :  
Ok
Doctor :  
Is the hemoglobin level normal?
User :   hmmmmmmm...I assume..they did a bunch of blood tests
Doctor :   Are you diabetic?

User :   no
Doctor :  
Do you take low salt diet?
User :   no
Doctor :   Wre you advised so?

User :   no
Doctor :   What is your weight and height?

User :   6'0" 220 lbs
Doctor :  
So you are over weight?
User :   I wouldn't say so..
User :   no one has ever mentioned it
Doctor :  
Ok
Doctor :  
From the history that yu have given I got some points to share with you on your health front
Doctor :  
The reasons for the weakness could be
Doctor :  
1) High Blood pressure which in not controlled with the Atenolol, Lisinopril and Hydrothalazide
Doctor :  
Surprisingly the medicine doses are not adjusted accordingly
Doctor :  
2) There might be a low hemoglobin issue which you are not aware of
User :   OK
Doctor :  
3) According to the BMI ( Body Mass Index ) calcualted on the weight and height you fall under Obese category
Doctor :  
4) You are not on strict diet measures
Doctor :  
which should be low salt and low fat diet
Doctor :  
You should know that the High blood pressure causes a pressure on the heart to pump blood to the other organs in your body
Doctor :  
and it strains a lot causing you anginal pain
Doctor :  
At those high blood pressure even if you work for more than 10 minutes
Doctor :  
and walk without gaps for few mts
Doctor :  
your heart strains and causes fluid to accumualate in lungs
Doctor :  
causing shortness of breath
User :   oh yeah and I have terrible coughing when lying down
Doctor :  
These are definitely not good signs
Doctor :  
This is called Orthopnoea
User :   but with the test that I've had we can be assured that there is nothing wrong with the heart ??
Doctor :   yes the heart is strained and not affected yet
Doctor :  
It is giving you signals in the form of these symptoms
User :   ahhhh I see
Doctor :  
that I may be affected if yoiu do not control your blood pressure
User :   O.k.
User :   Well I
User :   m going back to myy family Dr Thurs. so....
Doctor :   Yes you should

Doctor :  
Surprosingly the BP is controlled with weight loss
Doctor :  
and Good low salt diet
Doctor :  
with more of complex carbo\hydrates
Doctor :  
and low fat
User :   I'm really surprised that weight is an issue....most people are "fatter" than me
Doctor :  
So I sincerely request you to please take care of these things
Doctor :  
No table salt please
Doctor :  
Good night sleep improves the pressure control
User :   So in summation...it "hurting" my heart but tests don't show it yet ??
Doctor :  
Atleast 10% weight loss will cause major improvement in your lifestyle
Doctor :  
yes
User :   that makes sense
Doctor :  
Now ask your Family doc
Doctor :  
if you are not obese
Doctor :  
or Overweight
Doctor :  
I think he should tell you the truth
Doctor :  
Never late
Doctor :  
You can start concentrating now
User :   Oh I will...I just want ot be able to work again..
Doctor :  
You can
Doctor :  
if you can control the pressure and reduce the weight
Doctor :  
Do not skip medicines
User :   OK
Doctor :  
MOre importantly there are lifelong
User :   NEVER skip medicines
User :   wonder if they need dosage increase
Doctor :  
Do you take them regularly
User :   absolutely
Doctor :  
good
User :   plus nitro ~4 times a week
Doctor :  
Continue on them
User :   I guess that the nitro is helping by opening the vessels ??
Doctor :  
and watch the diet
Doctor :  
It helps
Doctor :  
yes
User :   OK
Doctor :  
I expect you to get back to me with some improvement by next week
Doctor :  
What do you say
User :   sounds good...I'll run this by my Dr.
Doctor :   Yes

Doctor :  
Watch your diet
User :   I will
Doctor :  
Visit a dietician if required to
Doctor :  
design a menu
Doctor :  
Ok
Doctor :   All the best then
User :   I'll do ANYTHING that I'm told at this point
User :   you also and thanks again
Doctor :  
Is there any thing
Doctor :  
else you want to talk to me
User :   no that gets me started in a new direction anyway
Doctor :  
Please fill the feedback form say done when done.
User :   done
Doctor :   Thanks for consulting
Doctor :  
Hope to see you soon
Doctor :  
after a cuple of weeks
Doctor :  
with better results
User :   will do
Doctor :  
Bye for now.
User :   bye
Question is related to
Diseases and Conditions
Drug/Medication
Lab Tests
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