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Went through angiography. Suggest on Medication and precautions required? Cholesterol is on higher side.

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Cardiologist
Practicing since : 1998
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I am 37 years, went through angiography in March 2013 post your recommendation on 9th Feb 2013. Kindly find attached my reports.
Suggest on Medication/precautions required if any. My Cholesterol is on higher side.
Posted Thu, 30 May 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 52 minutes later
Dear Mr. XXXXXX
Thanks for your query to XXXXXXX

I have seen your reports.

1. Your Angiogram showed normal coronaries.
2. Before commenting on your lipid profile, I wish to know something more from you. a. Do you have high blood pressure/ diabetes? b. Hope you never smoked. c. Is any blood relative of yours had heart attack/angina? If yes, at which age it started. d. Did you ever have stroke/ peripheral artery disease/kidney disease or any medical disorder worth mentioning?
3. What are your current symptoms? What happened when you run/exercise/jog/ use stairs?
4. If you can tell me how much you walked (duration) on TMT in February and what were your symptoms when you did TMT (What happened to you on TMT).

I am waiting for your response. I will discuss in detail afterwards.

Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Went through angiography. Suggest on Medication and precautions required? Cholesterol is on higher side. 3 hours later
Do you have high blood pressure/ diabetes? No
Hope you never smoked. I dont Smoke.
Is any blood relative of yours had heart attack/angina? No
d. Did you ever have stroke/ peripheral artery disease/kidney disease or any medical disorder worth mentioning? No

3. What are your current symptoms? What happened when you run/exercise/jog/ use stairs? I feel suffocated while climbing stairs, jogging or even when I walk for 1 KM. Feel pain in Jaws while walking(more than 1 KM or so).

4. If you can tell me how much you walked (duration) on TMT in February and what were your symptoms when you did TMT (What happened to you on TMT). I walked for 4-5 minutes.
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Dear Sir
Thanks for the details.
1. I calculated your target LDL as per current international guidelines and it should be ~160 mg% which is in fact 161 mg%. Your HDL is low and VLDL is higher than normal limits but do not worry. Your non-HDL cholesterol can be upto 190 mg% which is 208 mg%. It's management involves only life style modification at present. These are
a. Optimization of weight. (ideally it should be 68 Kg for an Indian. Try to get it at least up to 73 Kg). Consult a dietitian for ideal diet for you and exercise daily (try to increase your capacity slowly from your current level).
b. Avoid fried items. Take refined oil cooked food. Avoid too much of sweets and carbohydrates too.
c. Need to do daily exercise as mentioned above.
d. Do not take alcohol at all.
Once you do these things for ~3 months, repeat a lipid profile and if that is ok , continue with these measures, else you can discuss with us or your physician.
2. You need not to take any medications for heart per say on the basis of these reports. I hope your ECHO prior to angiogram was also normal. Let me know if there was any problem in it.
3. On the face of it your problems appear to be because of your weight.
4. Have you consulted a pulmonologist (chest physician) also to rule out any lung disease responsible for your symptoms? If not, please do so. PGIMER Chandigarh has a very good pulmonary medicine department, which is nearer to your place.
Feel free to discuss further.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by
 
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