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Suggest Treatment For Severe Chest Pain
Question: I had a stent fixed in my Coronary artery on 9 th November 2016 after a complete blocking. During the emergent actions to dilute/control the clogging, my heart stopped for 40 minutes. Since that date I am on Plavix, Exforge, Cristore and Concor 2.5 in addition to Jusprine.Chest pain is revisiting and my doctor said that such inflammation took place when the heart stopped and swelled and it will go with time.
Last week, I suddenly passed out for complete 45 minutes and I passed through a NDE with lots of weird visions.
To know the reason behind such incident, I carried out a dobbler on the neck aretries, an echo and fixed a holter for 48 hours due to the Dobbler doctor observation that the heart rate was severely fluctuating and my own measurements that proved same.
I am attaching hereto the a.m. analyses results for your assessment.
Last week, I suddenly passed out for complete 45 minutes and I passed through a NDE with lots of weird visions.
To know the reason behind such incident, I carried out a dobbler on the neck aretries, an echo and fixed a holter for 48 hours due to the Dobbler doctor observation that the heart rate was severely fluctuating and my own measurements that proved same.
I am attaching hereto the a.m. analyses results for your assessment.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I have passed carefully through your medical history and your uploaded tests and would like to mention a few issues to carefully consider:
According to the recent clinical symptomatology you have experienced (episodic passing out), coupled with a subsequent cardiac tests , the opinion about the most probable reason of your complaints goes for a potential complex and life-threatening cardiac arrhythmia (ventricular fibrillation or tachycardia, or torsades de pointes). This alternative is supported by the fact that you are suffering from dilated ischemic cardiomyopathy and the results of 48 hours cardiac rhythm monitoring (presence of ventricular extrasystolic arrhythmia, an abnormally prolonged QTc interval [473 ms], which predispose for complex ventricular arrhthmia).
Although no complex arrhythmia has been detected on Holter monitoring, these can not exclude their responsibility on your previous clinical symptoms.
Coming to this point, it is necessary to sought or potential causes that may trigger cardiac arrhythmia in the settings of dilated ischemic cardiomyopathy.
In this regard, I would recommend investigating several reasons as follows:
- a new recurrence of cardiac ischemia,
- blood electrolyte imbalance (Hypokalemia, Hypomagnesemia, Hypocalcemia),
- thyroid hormone levels.
For the same reasons, the following tests would be helpful:
- blood electrolyte levels,
- thyroid hormone levels,
- a cardiac stress test,
- dobutamine stress echocardiography
- nuclear perfusional cardiac stress test.
If evidence of cardiac ischemia is revealed, then a new coronary angiography is necessary.
Otherwise, if no cardiac ischemia is present, then the other above mentioned triggering factors should be corrected (electrolyte levels, thyroid hormones).
In face of cardiac arrhythmia responsibility in producing your recent clinical symptomatology and considering the fact that you are suffering from dilated ischemic cardiomyopathy, it seems reasonable to discuss with your attending cardiologist on the opportunity of implanting an internal cardioverter-defibrillator (ICD), which could protect you from potentially new episodes of lifethreatening cardiac arrhythmias.
Hope you will find this answer helpful!
In case of any other uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I have passed carefully through your medical history and your uploaded tests and would like to mention a few issues to carefully consider:
According to the recent clinical symptomatology you have experienced (episodic passing out), coupled with a subsequent cardiac tests , the opinion about the most probable reason of your complaints goes for a potential complex and life-threatening cardiac arrhythmia (ventricular fibrillation or tachycardia, or torsades de pointes). This alternative is supported by the fact that you are suffering from dilated ischemic cardiomyopathy and the results of 48 hours cardiac rhythm monitoring (presence of ventricular extrasystolic arrhythmia, an abnormally prolonged QTc interval [473 ms], which predispose for complex ventricular arrhthmia).
Although no complex arrhythmia has been detected on Holter monitoring, these can not exclude their responsibility on your previous clinical symptoms.
Coming to this point, it is necessary to sought or potential causes that may trigger cardiac arrhythmia in the settings of dilated ischemic cardiomyopathy.
In this regard, I would recommend investigating several reasons as follows:
- a new recurrence of cardiac ischemia,
- blood electrolyte imbalance (Hypokalemia, Hypomagnesemia, Hypocalcemia),
- thyroid hormone levels.
For the same reasons, the following tests would be helpful:
- blood electrolyte levels,
- thyroid hormone levels,
- a cardiac stress test,
- dobutamine stress echocardiography
- nuclear perfusional cardiac stress test.
If evidence of cardiac ischemia is revealed, then a new coronary angiography is necessary.
Otherwise, if no cardiac ischemia is present, then the other above mentioned triggering factors should be corrected (electrolyte levels, thyroid hormones).
In face of cardiac arrhythmia responsibility in producing your recent clinical symptomatology and considering the fact that you are suffering from dilated ischemic cardiomyopathy, it seems reasonable to discuss with your attending cardiologist on the opportunity of implanting an internal cardioverter-defibrillator (ICD), which could protect you from potentially new episodes of lifethreatening cardiac arrhythmias.
Hope you will find this answer helpful!
In case of any other uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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