Medical management should be continued.
Thanks for your query. I fully understand your concerns.
I have carefully gone through all your reports.
1. Firstly, a conventional angiography
is more specific, since there are some limitations of a CT Angiogram, as mentioned below the CT Angiogram report.
2. Exposure to radiation
in any manner is harmful to the body.
3. The CT Angiogram report mentions 70-80% blockage of Right Coronary Artery
. The standard teaching is that, Medical management is the treatment of First Choice. Angioplasty- with or without stent- should ideally be done when the blockage is about 90% or more; or, there is failure of medical management in controlling the symptoms. A BLOCKAGE OF 60% OR LESS, DOES NOT WARRANT ANGIOPLASTY.
4. You do not have any modifiable risk factors. Further, except for a single/first episode of anginal pain, the information provided by you makes neither any mention of any similar episode in the past; nor, having any symptoms at present. I am therefore, of the personal opinion that medical management, including preventive measures, should be continued till such time you have no symptoms.
5. Hence, in the light of the rationale mentioned in the preceding paragraph, I do not feel the necessity of going in for conventional angiography or angioplasty, for the time being.
6. Continue with medical treatment, which- along with dietary restriction, regular medication, regular exercises and maintenance of body weight to ideal BMI- would keep the heart condition under control. Angioplasty should be resorted to only when you develop ischemic symptoms, which fail to get controlled despite medical management.
7. I fully agree with your Fortis Cardiologist's prescription, though I am personally of the opinion that aspirin
75mg should also be taken along with Deplatt (Unless you are already taking Deplatt-A). The change in the treatment has been rightly made, taking significant blockage of Right Coronary Artery into active consideration.
8. Ramistar has been replaced by a more effective drug: Losar-A.
9. Lastly, Treatment is modified as per the requirement. The earlier treatment was catered to control blood pressure only. Now, with the diagnosis of heart disease
, it is but logical to modify the treatment accordingly. Rest assured that there will be no adverse effect.
Make sure that you consult your doctor at regular intervals.
Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any.
Fond regards and have a nice day,
Col (Dr.) Rakesh Karanwal