Brief Answer:
Further assessment / Life style changes & drugs / Follow up

Detailed Answer:
Hi friend
Welcome to Health Care Magic

The ECG is suggestive, not confirmative
It is an indication for further investigation for Coronary Artery Disease.
     You should go for TMT (Treadmill Exercise ECG) with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is any suggestion, the next step is to see the ANATOMY (structure) – undergo CT angio for the non-invasive study of the anatomy.
     If positive, you will need catheterisation, catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.]
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     Cardio work out is not necessarily advantageous here. Do regular exercise – say walking or jogging - 30 minutes a day / at least 5 days in a week. Isometric exercise (like bull worker) is bad.

There are subdivisions of cholesterol – LDL, HDL and so on. HDL is good cholesterol – higher, the better. LDL is bad cholesterol – lower, the better.
In the absence of any other risk factor 100 is ideal for LDL-C. In the presence of other diseases (especially Diabetes and/or established heart disease), 70 should be the aim. Your LDL is quite high…
     Keep your weight to normal / even a little less
     Quit smoking, if you are a smoker
     Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.
Continue the drug
Continue exercise
Repeat the test in 2 to 3 months. ..if still high, the dose may be upped and/or a second drug like Ezetimibe added

Good luck
God bless you

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Brief Answer:
Yes /

Detailed Answer:
Hi

1-     Yes – have them repeated – stress ECHO and CT angio / it is three years or more now
A negative CT angio is reassuring .. if symptomatic, we give CCB (Calcium Channel Blocker), aspirin and nitrates Follow up is a must… it is a priority… people often ignore and are noncompliant because of absence of symptoms… it is better to be safe than sorry
     There could be another interpretation… ‘Early Repolarisation Changes’ in ECG are very similar in appearance…. If ischemia is ruled out by the tests, have a second opinion from a specialist in arrhythmia (This sub-speciality expert is called ELECTRO-PHYSIOLOGIST)

2-     You have to change the QUANTITY of your food and the QUALITY too. It is not possible to
explain or understand the nuances on a single occasion. You should see a good DIETICIAN - One generally needs SEVERAL sessions, to master concepts of calories, nutritional values, biological value, vitamins, minerals and so on.

3-     Yes, Treadmill is generally safe… we often do it before discharging a heart attack patient….
It is better to have the first one under medical supervision

Regards

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Brief Answer:
Get tested

Detailed Answer:
Hi

Both tests are necessary

Absence of symptom (pain) is no proof of absence of disease….
The first symptom may be a catastrophe in some…

1.     ECHO is not enough – Stress test is a must in this situation
Preferably with thallium isotope
     If positive, it must be followed by angio

2.     It is not preferable to go for workout without the test – better be safe than sorry

Regards

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