Nagercoil, 27.06.2010. Kind Attn :Head of Cardiology,Apollo speciality hospitals,Chennai. I am S.Padmanabhan from Nagercoil,aged 45 ,no smoking,no alcohol,no drug,no moral problem,Diabatic from last year. My date of birth is 25.02.1964 ,45 years old,Residing at 75(69),Chidambara nager,Gandhi Nivas,Kottor,NAGERCOIL-629002,Kanyakumari district. Mob:0000.E-mail: YYYY@YYYY / YYYY@YYYY . The following is My Heart Problem â?? A detailed Report. (Hypertrophic Obstructive Cardiomyopathy ). When I was admitted for a Hydrocelle Operation in 1993,The duty doctors found a murmur sound from my heart and I was adviced to take a Echo.I have done my forst Echo at M/S.PRS Hospital,Trivandrum Kerala ,by Dr.Tiny Nair and the report says that â??Mild Asymetric Septal Hypertrophy,ANT Motion of AML in Systole,Mild MR,Mild Ivot Gradient amd Systolic Flutter of Ar Valve and Suggest to Mild Hypertrophic Obstructive Cardiomyopathy and suggested me Inderal 40 1-1-1 and Trika 0.25 at night 0-0-1. Sebsequently I was do echo every year.Then I had a chance to do my Check up With Amirtha Insitute of Medical Sciences,Ernakulam,Cochin on 03.11.2006 and I had taken Echo where the descriptive report as follows. Amirtha Insitute of Medical Sciences,Ernakulam ECHO Report. 5 mm fossa ovalis atrial septal defect with left and right flow.Normal pulmonary venous drainage.Normal left ventricular size. Hypertrophy of the basal anterior septum (22 mm).Severe hypertrophy of mid inferior.anterior and lateral walls.Mild midcavity resting obstruction (25 mm Hg).Grade III SAM.Significant resting LVOT gradient (85-110 mm Hg).Overall good LV systolic function(good radial,mildly impaired long axis function).The estimated left ventricular ejection fraction is 55%.No regional wall motion abnormality.E/Ve=12.The left atrium is moderately dilated.PV â??aâ?? duration is 52 ms more than mitral â??Aâ?? indicating elevated LVEDP.The aortic valve is normal.No coarctation. The Pulmonic valve is normal. The Pulmonary artery is mildly dilated.the right artial size is normal. The right ventricle is normal in size and function. The tricuspid valve is normal. RVSP=50 mm Hg.The Pericardium is normal. Hypertropic obstructive cardiomyopathy/significant resting LVOT obstruction/ Mild mid cavity obstruction/moderate mitral regurgitation/Small fossa ovalis atrial septal defect with left to right flow/Moderate PAH/Good RV function. Again ECHO was done on 19.6.2008.at JK Hospital,Nagercoil by Dr.N.Jayaseelan. ECHO Report Exteacts The Doctors Impressions are as follows. Hypertrophic Obstructive Cardiomyopathy. Asmmetric Hypertrophy of Septal Antero Septal & Anterior walls at base & mild LV levels and also Lateral wall at Apical Level. Dilated Left Atrium. Systolic Anterior Motion of Mitral valve. Severe Left ventricular outflow obstruction.(Peak Gradient 89.8 mmHg). Mitral Regurgitation â?? Mild. Normal Left Ventricular systolic Function (EF 87%). Mild left Ventricular Diastolic Dysfunction. Occasional Ventricular Premature Beats+. My Present Problems Unable to walk ,and Sleep in flat bed position.Become very tired frequently and feeling chest heaviness when ever I take full Break fast/Lunch/Supper.Heaviness starts after 15 to 20 mts of food intake.Severe pain in hand shouldes.This continues for a hour and I become to normal.Very difficult to walk in up hill areas/gradients.Just 3 months back my Blood sugar level started to 195.Now Iam able to maintain to 145. Just 2 months back, Low lipido also started.So I contacted my Cardiologist.He informed that this may due to the Intake of Inderal Tablet from 1993.After taking calaptin 120SR it is solved to some extent. When ever I take food in all times,I get pain,palpitation and heaviness till it get digest.I also frequently feel hunger.If I took meals from a function,marriage,after 15 mts i feel very much heaviness.I may not able to walk .Mentally,i am forced to take soda.If i take soda,after half an hour I will back to 75% normal within 15 mts. I was very comfortable if I take Inderal tablet,but this has Low lipido Side effect.I also browsed got this message from web sites.Now ,My Dr changed my tab from INDERAL 40 to DILZEM 30 at 1-1-1. Now I am taking Dilzem 30 at 1-1-1 and Ubi Q Plus at 1-0-0.And Amaryl 1 mg at 1-0-0 for Sugar. Again,I had a consutation with Dr.K.U Nartarajan of m/s Amirtha Hospital,Ernakulam who comes to Nagercoil every monthly and I had a chance to consult him on 9.11.2008,and he advised me to do â??Alcohol septal ablationâ?? and Angio gram at the earlist.He also informed me that when we do the Angiogram,by that time only this Alcohol septal ablation can be done.Is this Alcohol septal ablation cure my problems or we have to for Myectomy. On 9.11.2008 Dr.Natarajan changed the Medicene from DILZEM 30 to Calaptin 120SR 1-0-0 and Ditide �½ tab in 1-0-0. Then I showed with Dr.Dr.G.Vijayaraghavan,Chief KIMS,Trivandrum.He changed the following medicines. My Present Medicines are as follows. Lopressor 50: 1-0-1. Amariyal : 1 mg 1-0-0. UBI I Q Plus : 1-0-0. Rosuvas 5 : 0-0-1. Hirudaya santhi syrup given by Santhi asramam,Kerala 25 ml 1-1-1. My present Major health complaints are as follows: I am feeling the heaviness during morning walk and when ever i take food in the morning,Lunch,dinner.See after taking food say about 15 to 20 mts the heaviness starts from my chest and later transfer to shoulder and hand.When I feel more pain i star using of Soda.If i take sode then i will be comfortable with in half an hour.This soda taking is happening max of time and during marriage function,party food etc. also.I am here by forwarding my old report in a seperate attachment.Now i feel that, i may be having blocks.For this can u how can I lead a trouble free ,operation free life.I am unable to climb uphill also.If i do 128 slice scan or angiogram,wheather i get good information about heart.Is there any better medicine to shape up my life. Thank You. Yours, S.Padmanabhan, SKP Super Market,KP Road,Nagercoil. 0000.