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Have chest pain. All test done. Taking medicines. Is angiogram required?

My mother who is 52 years old has consulted with a cardiologist recently.The doctor gave some test like X-Ray Chest P/A View,ECG,Eco(2D),Lipid profile etc.Among the reports X-ray, ECO,Lipid profile is ok but in ECG report there's a comment like Infero lateral Ischemia.Doctor suggests her to do Angiogram(CAG) test.Is it necessary to do the test?My mother feels chest pain sometimes for a few minutes.Also Osteoarthritic change in her right knee joint is identified by X-ray.Doctor Prescribed the following medicines for both knee pain and chest pain,and blood pressure:1.Aceclofenac 100 mg 2.Pantaprazole 20 mg 3.Calcium 500 mg &200I.U Cholecalciferol(vitamin D3) 4.Losartan potassium 50 mg &Hydrochlorothiazide 12.5 mg 5.Nitroglycerin USP 2.6 mg 6.Atorvastatin 10 mg 7.Clopidogrel 75 mg. 8.Metoprolol Tartrate 50 mg.I am waiting for your wise suggestion.Thanks
Asked On : Sat, 30 Mar 2013
Answers:  2 Views:  115
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Orthopaedic Surgeon 's  Response

Thanks for writing in,

Since your mother is 52 yr old and hypertensive, it is better to get an angiogram (CAG) done. This will help us identify the cause for infero-lateral ischemia. If there is a block in heart vessels, she might need some stenting which could prevent some serious adverse events.

She can take the mentioned drugs for her Osteo-arthritis of Knee, Hypertension and Chest pain. As a prophylaxis, your doctor has already prescribed her some cardiac medications that will help her in relieving chest pain and prevent further blockade of her heart vessels.

Ask her to avoid using stairs, squatting & sitting cross legged. Ask her to take diets less of fat / oil and more of high fiber contents. Regular jogging and walking can be done if her knee supports them.

Wish her a good health.
Answered: Sat, 30 Mar 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

Yes...she must go for angio...
ECG changes are not always specific or proportional to the severity / it is an indication for further work up.
Angiogram is an investigation. It will detect blocks – its presence, location, extent, its severity and feasibility of intervention. Left ventricle (lower heart chamber) and its function is assessed – wall motion, ejection fraction, pressure, saturation are all documented. It is the only way to directly ‘see’ the block / it is the gold standard against which all other investigations are compared.
The aim of any investigation is to modify the treatment, based on the result. In this case, to prevent heart attack. Go ahead and have angio...

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Fri, 3 May 2013
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