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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How healthy is the heart as per the attached reports?

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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Posted on Tue, 22 May 2018 in Hypertension and Heart Disease
Question: My Father has been gone through the medical health check-up.I need your input over the attached reports.Mainly i want to know the health of the heart. And what we need to do next.
doctor
Answered by Dr. Rishu Saxena 1 hour later
Brief Answer:
Very low cardiac risk should start medicine for blood sugar and lipids

Detailed Answer:
Hi sir,
Thanks for asking query on this forum,
I am a cardiologist and would be answering your queries

His echo shows mild aortic stenosis.His age is 62.As our age increases our body starts aeging.Mild to moderate changes in valves or any other parts of heart are not something serious at age of 62.
As per the report his aortic jet velocity falls in mild stenosis category.
Mild AS is very common after age of 45 in XXXXXXX and is usually due to deposition of calcium on walls of valve causing mild reduction in opening diameter of that valve.
As per Branwards cardiology(Bible of a cardiologist) -Patients with mild aortic stenosis do not require treatment or restriction of activity and its a very slow progressing disease .So even if it would progress at maximum rate it would take atleast 15 years for any surgical intervention.

His lipids are deranged and he should take tablet Atorvastatin 20 mg once daily before going to sleep for 3 months.Repeat a lipid profile after 3 months again.
Olive oil should be used for cooking.
If possible treadmill walk should be done for 20 minutes at 6km/hr speed.
Add fiber supplements to his diet.

His sugar levels are elevated and HBA1C is high.
Should start taking tab Metformin 500mg twioce daily before breakfast and dinner.
Repeat HBA1C after 3 months.
ECG is normal.

Kidney is effected due to high blood sugars once sugar is controlled GFR would become normal.


Finally i don't think he has to worry too much just start medications.
Feel free to ask follow up query.
Thank you!

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rishu Saxena 3 hours later
Thanks doctor for the detailed answer.
My father is taking medicine triglynase1 before lunch for the last one month.Before that for the last one year my father was taking medicine glycomet before lunch.Please advice if we need to change the medicine as you have mentioned or need to visit the diabetologist.
doctor
Answered by Dr. Rishu Saxena 8 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hi Sxxxxxx,

As per your query, he is already on basic antidiabetics and still, things are not in control.
A better suggestion would be to visit an Endocrinologist and get treatment reviewed.
S/he may add further medications like gliptins or voglibose.

A matter of concern is that his A1c is high despite taking antidiabetics which means that long-term control of sugar is not good (this is something not good).

Maybe long-acting insulin like Lantus or Mixed insulins like Mixtard prescribed to him for few weeks to control his HbA1c.

I can also do so but you can understand that endocrinologists are trained exclusively for this thing only.

From my side statins should be started.
Asprin baby dose 75 mg can also be taken for 3 months for a better cardioprotection as diabetes is not in control and dyslipidemia is also there.

So from my side treatment advised is-
Tab Atorvastatin 20 mg 1 HS
Tab Ecosprin 75 mg 1 HS
HS means bedtime.
A herbal product named Prelipid tablet could also be added twice daily dose.
For diabetes, I would refer him to an Endocrinologist.

Regards!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rishu Saxena 2 hours later
Thanks doctor for in-detail explanation and clarifying my doubts.
doctor
Answered by Dr. Rishu Saxena 21 minutes later
Brief Answer:
Regards.

Detailed Answer:

Thanks for the appreciation.
Good luck and get well soon!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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