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What Does This Blood Report Indicate?
Question: sir, Kindly go through my previous case history if possible on this website. My present condition is as under:
Since two years i am taking CLOPILET-A (CLOPIDEGROL AND ASPIRIN) 75/150 AND OLMEZEST 20MG as i was dignosed for hypertension, dyslipedemia, hypothyroidism, athero sclerotic cartoid artery stenosis bilateral 10% narrowing, ischemic cerebrovascular accident in the region of corona radiata with no major neurological deficit.
AT THAT TIME MY ECHOCARDIAGRAM (2D ECHO) WAS NORMAL - DOPPLER -NORMAL STUDY.
BRAIN MRI - BOTH ICA ARE TORTEOUS - SMALL CALCIFIED PLAQUE MEASURING 0.18%X0.10 CMS IN LEFT ICA CAUSING ABOUT 5-10% STENOSIS.
ABOVE ARE MY PREVIOUS MEDICAL HISTORY.
I AM TAKING MEDICINES SINCE TWO YEARS (OCT 2014).
NOW , RECENTLY I AM FEELING STRAINED/SOME TIMES HEART BEAT RAPIDING FEELING WHILE SITTING/LYING DOWN. SO, I WENT TO FOR A CHECKUP AGAIN.
MY PRESENT MEDICAL REPORT ARE AS UNDER:
1. NORMAL ECG.
2. HAEMOGLOBIN - 13.2
3. ESR - 11
4. RBC COUNT 4.18
5. POST PRANDAL BLOOD SUGAR 104
6. LDL 130.8
7. HDL 41.4
8. CHOLESTROL RATIO 4.54:1
9. TOTAL CHOLESTROL 188
10.TOTAL TRIGLYCERIDES - 79.8
11. TSH - 5.19
2D - ECHO - DOPPLER:
ALL VALVES - NORMAL
NO CLOTS
DOPPLER _ MILD TRICUSPID REGURGITATION - TR JET-2.5m/sec.
no wall motion abnormality, LV contractility adequate, no vegetations/clots/pericardial effusion.
LVEF 62%.
Kindly guide whether i have to change medicine or need further treatment/operation etc? My doctor is a general physician who has prescribed all these medicines and he is one of the doctors in the Hospital where i am visiting regularly.
Since two years i am taking CLOPILET-A (CLOPIDEGROL AND ASPIRIN) 75/150 AND OLMEZEST 20MG as i was dignosed for hypertension, dyslipedemia, hypothyroidism, athero sclerotic cartoid artery stenosis bilateral 10% narrowing, ischemic cerebrovascular accident in the region of corona radiata with no major neurological deficit.
AT THAT TIME MY ECHOCARDIAGRAM (2D ECHO) WAS NORMAL - DOPPLER -NORMAL STUDY.
BRAIN MRI - BOTH ICA ARE TORTEOUS - SMALL CALCIFIED PLAQUE MEASURING 0.18%X0.10 CMS IN LEFT ICA CAUSING ABOUT 5-10% STENOSIS.
ABOVE ARE MY PREVIOUS MEDICAL HISTORY.
I AM TAKING MEDICINES SINCE TWO YEARS (OCT 2014).
NOW , RECENTLY I AM FEELING STRAINED/SOME TIMES HEART BEAT RAPIDING FEELING WHILE SITTING/LYING DOWN. SO, I WENT TO FOR A CHECKUP AGAIN.
MY PRESENT MEDICAL REPORT ARE AS UNDER:
1. NORMAL ECG.
2. HAEMOGLOBIN - 13.2
3. ESR - 11
4. RBC COUNT 4.18
5. POST PRANDAL BLOOD SUGAR 104
6. LDL 130.8
7. HDL 41.4
8. CHOLESTROL RATIO 4.54:1
9. TOTAL CHOLESTROL 188
10.TOTAL TRIGLYCERIDES - 79.8
11. TSH - 5.19
2D - ECHO - DOPPLER:
ALL VALVES - NORMAL
NO CLOTS
DOPPLER _ MILD TRICUSPID REGURGITATION - TR JET-2.5m/sec.
no wall motion abnormality, LV contractility adequate, no vegetations/clots/pericardial effusion.
LVEF 62%.
Kindly guide whether i have to change medicine or need further treatment/operation etc? My doctor is a general physician who has prescribed all these medicines and he is one of the doctors in the Hospital where i am visiting regularly.
Brief Answer:
please see details below
Detailed Answer:
Dear Sir
1. Once there is an ischemic cerebrovascular event, one has to take a group of drugs called statins, life long, unless there is a contraindication.
2. Clopidogrel in addition to aspirin, in stroke, is given only for specific subset of patients like diabetics or those who were already on aspirin and develop stroke.
3. The reports mentioned by you above are within normal range.
Hence, Kindly provide the following information.
1. If you are a diabetic.
2. Why did you stop rosuvastatin?
3. If you do some kind of brisk walk/ jogging or exercise ? What happens to your symptoms during exercise or while using stairs.
Sincerely
Sukhvinder
please see details below
Detailed Answer:
Dear Sir
1. Once there is an ischemic cerebrovascular event, one has to take a group of drugs called statins, life long, unless there is a contraindication.
2. Clopidogrel in addition to aspirin, in stroke, is given only for specific subset of patients like diabetics or those who were already on aspirin and develop stroke.
3. The reports mentioned by you above are within normal range.
Hence, Kindly provide the following information.
1. If you are a diabetic.
2. Why did you stop rosuvastatin?
3. If you do some kind of brisk walk/ jogging or exercise ? What happens to your symptoms during exercise or while using stairs.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Raju A.T
Sir, doctor told me to continue only clopilet with asprin (ClopiletA) and Olmezest20mg.
I feel chest burning/ tiredness if i try to climb beyond 2nd floor. That means i feel chest burning While reaching third floor onwards and steep up roads. Some timres even on even roads for few minutes. After taking rest for some times the chest burning vanishes. Actually i am a chronic walker since childhood. Since 4-5 years my walking reduced due to changed life style.
Whether clopilet causing regurgation?
About two years back there was no regurgation as pet my earler doppler reports -it was normal. Same cardialogist conducted echo test both times.
Sir i am not diabetic as per reports
I feel chest burning/ tiredness if i try to climb beyond 2nd floor. That means i feel chest burning While reaching third floor onwards and steep up roads. Some timres even on even roads for few minutes. After taking rest for some times the chest burning vanishes. Actually i am a chronic walker since childhood. Since 4-5 years my walking reduced due to changed life style.
Whether clopilet causing regurgation?
About two years back there was no regurgation as pet my earler doppler reports -it was normal. Same cardialogist conducted echo test both times.
Sir i am not diabetic as per reports
Brief Answer:
please see detailed reply.
Detailed Answer:
Dear Sir
1. Clopilet does not cases regurgitation.
2. This degree of tricuspid regurgitation, i.e. Mild with normal pressure, is not alarming and can very well be a normal variant.
3. Since you have chest burning on using two flight of stairs and it subsides on rest, you require further evaluation. This may be indicative of angina.
4. I normally advise a treadmill test in all my patients with such symptoms, provided other things are conducive or I advice them an imaging based stress test which may be stress ECHO or stress nuclear MPI scan.
5. I advise you to take another consultation, in person, and discuss about usefulness of stress testing with your cardiologist.
Sincerely
Sukhvinder
please see detailed reply.
Detailed Answer:
Dear Sir
1. Clopilet does not cases regurgitation.
2. This degree of tricuspid regurgitation, i.e. Mild with normal pressure, is not alarming and can very well be a normal variant.
3. Since you have chest burning on using two flight of stairs and it subsides on rest, you require further evaluation. This may be indicative of angina.
4. I normally advise a treadmill test in all my patients with such symptoms, provided other things are conducive or I advice them an imaging based stress test which may be stress ECHO or stress nuclear MPI scan.
5. I advise you to take another consultation, in person, and discuss about usefulness of stress testing with your cardiologist.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Sir,
When i was admitted to hospital about two years back (02-10-2014), echocardiagram was done and in that report DOPPLER study was normal-no regurgitation mentioned.
After two years this has come. Whether this is because of age factor? or medications? My family physician suggested me to get CHEST CT SCAN and he opined that it may be due to nerves weekness. Kindly guide.
When i was admitted to hospital about two years back (02-10-2014), echocardiagram was done and in that report DOPPLER study was normal-no regurgitation mentioned.
After two years this has come. Whether this is because of age factor? or medications? My family physician suggested me to get CHEST CT SCAN and he opined that it may be due to nerves weekness. Kindly guide.
Brief Answer:
please see details below.
Detailed Answer:
Dear Sir
1. There can be multiple reasons for development of this mild regurgitation which may include a normal degeneration with age, missing some degree of regurgitation on first ECHO, recent episode of respiratory tract infection and so on. As I have told you previously, it is not alarming.
2. I can not say anything bout the opinion of your GP, however, I do not advise CT chest to my patients with MILD TR and peak velocity of 2.5 m/s.
Sincerely
Sukhvinder
please see details below.
Detailed Answer:
Dear Sir
1. There can be multiple reasons for development of this mild regurgitation which may include a normal degeneration with age, missing some degree of regurgitation on first ECHO, recent episode of respiratory tract infection and so on. As I have told you previously, it is not alarming.
2. I can not say anything bout the opinion of your GP, however, I do not advise CT chest to my patients with MILD TR and peak velocity of 2.5 m/s.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Nagamani Ng
sir,
my doctor has advised me to take vitamin test. so i did. following are readings.
Vitamin B 12 - 98.17
Vitamin D3 25.9.
So he has advised to take B12 injections (10) alternate days and to take D3 tablets for six months.
So far i have taken 3 doses (3 days alternates).
Today i ate Lion Dates ; i got allergy reaction; itching near my eye edges and slight swelling. I took allegra-180. Yesterday also I had taken Lion Dates ; but didnt happen anything. surprisingly today i got allergy.
Moreover if i eat Karbuja fruit and south kanara dish (dryfruit laddu) i get allergy.
Sometimes i feel breath choking very slighly/suddenly.
Whether i have to undergo any other tests? KIndly advise.
my doctor has advised me to take vitamin test. so i did. following are readings.
Vitamin B 12 - 98.17
Vitamin D3 25.9.
So he has advised to take B12 injections (10) alternate days and to take D3 tablets for six months.
So far i have taken 3 doses (3 days alternates).
Today i ate Lion Dates ; i got allergy reaction; itching near my eye edges and slight swelling. I took allegra-180. Yesterday also I had taken Lion Dates ; but didnt happen anything. surprisingly today i got allergy.
Moreover if i eat Karbuja fruit and south kanara dish (dryfruit laddu) i get allergy.
Sometimes i feel breath choking very slighly/suddenly.
Whether i have to undergo any other tests? KIndly advise.
Brief Answer:
please see detailed reply.
Detailed Answer:
Dear Sir
1. If your doctor has advised you supplementation for Vitamins, you can take it.
2. Regarding allergy to lion dates, muskmelon or dry fruits, you must consult an immunologist or internal medicine specialist.
3. For you cardiac condition, we have already various possibilities.
4. For sudden onset breath choking, there can be local problems or problem related to lungs {especially in view of various allergies}, However, without examination other possibilities can not be ruled out and no tests can be prescribed as such.
Sincerely
Sukhvinder
please see detailed reply.
Detailed Answer:
Dear Sir
1. If your doctor has advised you supplementation for Vitamins, you can take it.
2. Regarding allergy to lion dates, muskmelon or dry fruits, you must consult an immunologist or internal medicine specialist.
3. For you cardiac condition, we have already various possibilities.
4. For sudden onset breath choking, there can be local problems or problem related to lungs {especially in view of various allergies}, However, without examination other possibilities can not be ruled out and no tests can be prescribed as such.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Prasad
sir,
Kindly inform me what are the other Diagnostic tests to be undergone to take care of my cardio/lungs health condition.
About a year back my Lungs Function Test report says "POSSIBLE RESTRICTIVE DEFECT". During test; my breath choked for a while and afterwards got setright.
So,
Kindly let me know whether additional cardiological tests/Lungs tests to be undergone, so that i will take those test for better health analysis.
Kindly inform me what are the other Diagnostic tests to be undergone to take care of my cardio/lungs health condition.
About a year back my Lungs Function Test report says "POSSIBLE RESTRICTIVE DEFECT". During test; my breath choked for a while and afterwards got setright.
So,
Kindly let me know whether additional cardiological tests/Lungs tests to be undergone, so that i will take those test for better health analysis.
Brief Answer:
please see detaield reply.
Detailed Answer:
Dear Sir
1. Any test in medical sciences is performed based upon the symptoms of patient. Only a few tests can be advised without a clinical lead. Moreover, tests performed without a clinical lead may lead to harm rather than benefit.
2. For cardiac evaluation pertaining to your symptoms, we have already discussed. Please refer to paragraph 4 of my second answer to you (on 23th October). I have detailed that what we normally do in these circumstances.
3. As I detailed in my last answer, first of all consult an internal medicine specialist or a pulmonologist, Only then they can decide that which test is best for your complaint of choking sensation. It will also decide if you require any test or not.
Hope this clears your doubt about the tests.
Feel free to discuss further.
Sincerely
Sukhvinder
please see detaield reply.
Detailed Answer:
Dear Sir
1. Any test in medical sciences is performed based upon the symptoms of patient. Only a few tests can be advised without a clinical lead. Moreover, tests performed without a clinical lead may lead to harm rather than benefit.
2. For cardiac evaluation pertaining to your symptoms, we have already discussed. Please refer to paragraph 4 of my second answer to you (on 23th October). I have detailed that what we normally do in these circumstances.
3. As I detailed in my last answer, first of all consult an internal medicine specialist or a pulmonologist, Only then they can decide that which test is best for your complaint of choking sensation. It will also decide if you require any test or not.
Hope this clears your doubt about the tests.
Feel free to discuss further.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
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