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Medications for left ventricular hypokinesia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Good Posted in: Valvular Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2208 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   Hi
User :   This is regarding my father's problem
User :   he had echo of his heart yesterday
Doctor :   Ok
User :   and it reports global left ventricular hypokinesia
User :   and shows 24%
Doctor :   Ok
User :   and normal value is 67% (+- 8%)
User :   he has breathing problem..
Doctor :   Ok
User :   gets tired very often
User :   so just wanted to know how severe it is ?
User :   and what are the things that we should take care of
Doctor :   May I know since when is he having the breathing issues?
User :   last 2-3 months...
Doctor :   May I know the reason why the ECHO was done?
User :   doctor recommended
User :   local doctor
Doctor :   Does he have any other medical illness such as diabetes, high blood pressure, heart disease, kidney disease, bronchial asthma?
User :   no....
Doctor :   Ok
Doctor :   let me brief you.
User :   sometimes high BP
User :   but not too often
User :   day before yesterday we visited doctor
User :   and BP was 110 150
Doctor :   Left ventricular hypokinesia values indicates the function state of the heart.
Doctor :   Any value below the recommended range(on an average, its considered as 50% indicates a failing heart)
Doctor :   This is probably responsible for his breathing issues and tiredness.
Doctor :   This is a chronic conditions and it's unlikely
Doctor :   that it can be reversed.
Doctor :   However further worsening of the condition can be avoided.
Doctor :   The measures that needed to be followed to avoid further worsening are simple
Doctor :   1. Your dad needs just the right amount of oral fluids, nothing more than recommended and nothing less than that.
Doctor :   Most cardiologist recommended not more than 1 litre of water per day(this includes all forms of liquids and the amount of liquids in his food)
Doctor :   2. Regular medications to help the heart to pump adequately.
Doctor :   Common medications that are used are digoxin, betablockers and other supportive medications to help proper breathing.
Doctor :   3. Watch out for worsening of breathing, swellings, sweating and so on.
Doctor :   If such symptoms appear, he needs immediate attention.
Doctor :   Are you following?
User :   yes
User :   he had worsening of breathing and sweating
User :   once
User :   around 3 months back
User :   he also has lot of dry cough
Doctor :   Finally, a failing heart usually is accompanied by other heart problems such as coronary heart disease, where in other investigations that include an angiogram is necessary.
User :   as well
Doctor :   Ok
User :   How severe it is at the current stage? shall we go to Escorts, Delhi for consultation
User :   with LVEF = 24%
Doctor :   Like I mentioned earlier, normal average values in a normal individual is 50%.
User :   ok
Doctor :   That means his functions are 50% of the normal.
Doctor :   This is fine as long as his fluid intake is kept under control.
Doctor :   High fluid intake can worsen the condition.
Doctor :   that could mean trouble.
Doctor :   Hence if you watch out his fluid intake(as specified by a cardiologist) and regular medications,
User :   by fluid you mean liquid intake (tea + milk + water + juice etc.) ?
Doctor :   plus restriction of activities, not involving in physical exertion
Doctor :   he can lead as normal life as possible.
Doctor :   Fluid intake includes all form of fluids(water, tea, milk, coffee, juice, plus the fluids in his other diets).
Doctor :   Since, I am unable to physically examine your dad,
Doctor :   I am unable to exact fix, the amount of fluid your dad has to take.
Doctor :   I hence suggest that you consult a cardiologist once,
Doctor :   he will be able to recommend the exact fluid that your dad has to take,
Doctor :   in the mean time, perform other evaluations such as an angiogram(if necessary) and will able to guide you in monitoring the dose of medications that he needs.
Doctor :   Have you followed what I have suggested?
User :   yes
User :   what is angiogram?
Doctor :   Angiogram is the study of the structure of arteries.
Doctor :   CAD (coronary artery disease) is one of the commonest cause for failing heart.
Doctor :   A coronary angiogram can be done, to visualize coronary arteries ( the arteries of the heart) for any blockages.
User :   these are kind of tests ?
Doctor :   If there are blockages, adequate treatment of the blockage are necessary to prevent future complications.
Doctor :   Yes,
Doctor :   its a test,( an endoscopy guided test).
User :   alright
Doctor :   The cardiologist after physical examination and review of the echo will suggest, if its suitable to get this test.
Doctor :   If its necessary and feasible, I suggest you opt for the test.
Doctor :   The angiogram will provide useful information in managing the present condition.
Doctor :   Have you followed what I have suggested/
User :   yes..
Doctor :   Do you have any other query?
User :   No that's all for now
User :   thank you
Doctor :   This is Dr XXXXXXXX here.
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
User :   bye
Doctor :   Wish you and your dad good health.
Doctor :   Have a great day!!!
User :   thanks
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