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Breathing Issues While Climbing Stairs, Whole Body Check Up Done. Analysis?

Posted on Tue, 28 May 2013

Question: Greetings Doctor
My name is XXX XXXXXXX (Indian)
Age 63 Years
Weight 69
Height 172
Non smoker, non Alcoholic

I used to have breathing problem when climbing stairs therefore
I went under Whole Body Check up

TMT result :
"ST segment response Mildly positive (Correlate clinically)
exercise tolerant GOOD
so preferred to go under Angiography
The results were:
Indication
Coronary Artery Disease
Dspnoea on exertion NYHA II

Access:
Route Right radial Approach Sheath Size 5F
Catheter Tiger 5F

Pressure:
AO 140/78 mmHg

LV Angiography : Not Done
Dominance RCA

Coronary Angiographic Profile:

Left Main      Normal
Left Ant. Desc.     Requiring present in proximal Segment
Diagnonal-1 Ostial 75 % stenosis, length is discrete, Contour is smoth
type is concentric. Distal vessel has TIMI 3 flow. Small vesseol

Diagnol -2 Normal
Left Circumflex: Normal
Obtuse marginals-1 : Normal
Obtuse marginals-2 : Normal
RCA :Normal
Post Desc. : Normal
Postier Lateral Branch : Normal

Complications: Nil

Final Impression:
Non-Critical CAD (Single vessel Diese)

Plan: Medical therapy

Lipid Profile:
Total Cholesterol          90
HDL Cholesterol          36
LDL Cholesterol          90
VLDL Cholesterol          9
Triglycerides          82
LDL:HDL ratio          2.5
CHOL:HDL ratio          3.75

PSA 0.75
ECG Normal

ECHO Final Impession:
NO LV regional wall motion abnormality
Trace TR PASP = 30 mmHg
Good LV and RV systolic function
LVEF=65%

THYROID PROFILE
Free T3     1.940
Free T4     1.218
TSG     5.644

Glucose (F) 100
Glucose (PP) 160
HbA1c 6.30

BUN 12.00
Creatinine 0.98
Uric Acid 7.30

How serious is my condition, please advise

Answered by Dr. Maruti Karale (38 minutes later)

Hello Mr.XX XXXXXXX

Thanks for the query.

Your angiography report shows that you have non-critical coronary artery disease (Ischemic heart disease).

This means that major vessels of your heart are normal. Only one small diagonal branch is affected on left side. You will not need any further interventions for your coronary artery disease. There is no need of angioplasty or coronary bypass graft.

But you are at further risk of getting blockage in other vessels in future.
Hence, you need to continue medical treatment as advised by your doctor to prevent further damage.

This treatment help you in preventing progression of coronary artery disease.

You lipid profile, blood sugar, thyroid profile and creatinine are normal.

Diet, exercise and medical management will be sufficient for your present coronary artery disease.

Hope this answers your query.
Thank you.

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Maruti Karale (45 minutes later)

Thanks Doctor,
Is my blood pressure (Hypertension) and short breathing is caused by this
LAD D1 or there could be some other reason

Medical Advice prescribed by Doctor
Tab Amlodepin 2.5. mg OD
Tab Febujet 40mg OD
tab Rosuvas 10mg OD
Tab Pentocid 40mg OD
Tab Glycomet 500 mg OD
Is it OK

Regards

XX XXXXXXX

Answered by Dr. Maruti Karale (6 hours later)

Hello,

Thanks for the reply.

Your high blood pressure could be due to age related atherosclerosis. Hypertension is not related to your present coronary artery disease.

Shortness of breathing can be due to stenosis of diagonal branch.

Your doctor has prescribed all essential medicines hence you can continue it.

Hope this answers your query.

Thank you.

Above answer was peer-reviewed by : Dr. Raju A.T