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Suggest Remedy For Heavy Breathing And Pressure In Chest With High BP

Posted on Thu, 7 Jan 2016

Question: my grand mother 86 years old gets little heavyness on chest and heavy breathing while walking or using stairs.we had consult a local doctor who said that BP is slightly above normal and asked for ECG.ECG report is attached.She is religios and doesnt consume medicine at night.The doctor had advised CTD-12.5,Deriphyllin,sovigourd-A and given an injection LASIX. What do you advise? she doesnt want to get admitted now to the hospital. what precautions and further investigation can we do on her?

Answered by Dr. Anantharamakrishnan (43 minutes later)

Brief Answer:
Drugs when she agrees / may try skin patch?

Detailed Answer:
Hi friend
Welcome to Health Care Magic

The situation could be a threatened heart attack
She needs to be investigated for Coronary Artery Disease.

The ideal option is admission, observation, and investigation. Since she is refusing this, even medicines at night – we have to wait till the morning and repeat the investigations – ECG, Blood test for cardiac marker (Enzyme levels for heart injury) / and ECHOcardiography.
Give the drugs, as soon as she agrees. Discuss with your doctor and add Aspirin and Clopidogrel (300 mg each is usually the loading dose)
Now, you may apply nitro-glycerine patch or ointment on the skin.. it may be difficult to get / your doctor may know local availability and arrange

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (44 hours later)

The blood test report is as follows-
Troponin is 0.12 ng/ml
Erthrocytes is 4.26 mlln per cu mm
Packed cell volume PCV is 34.8
Haemoglobin is 11.2
ESR is 32
MCV is 81.8
Injection given is fondaparinux sodium sterlie sln
medicines are telmisartan IP
Dytor plus 10 of cipla,
Esomeprazole magnesium and domperidone capsules,
These are once in morning
And for evening-
Clavilip 20
Montelukast sodium, levocitrizine hydro,acebrophylline,,,
Attached is the ECG report as of now,,
Please advice

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
Follow up again

Detailed Answer:
Hi

Follow up again tomorrow / And after one week
Follow up with a cardiologist (Heart Specialist)
Repeat Troponin / also CK & CKMB
Have an ECHOcardiogram
Continue the treatment
A small heart attack (at the back of the heart) is the likely underlying cause

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Anantharamakrishnan (3 days later)

Today an ECG had done its photo is attached ,, BP is normal, she is on complete bed rest , no breathing problem observed from past two days.

Answered by Dr. Anantharamakrishnan (7 hours later)

Brief Answer:
Good / no complications

Detailed Answer:
Hi

ECG is stable / no further changes or complications
Continue treatment as before

She must do deep breathing and movement of legs and feet, while lying in bed.
She can sit at the edge of the bed for a few minutes at a time / and in a day or two sit at a chair..
Give small frequent feeds
Not to strain / stool softeners may be given
Start gradual rehabilitation by the end of the week
Keep following up with her doctor

Regards

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

Follow up: Dr. Anantharamakrishnan (10 hours later)

Here is the list of medicines given by the doctor,, please check ,, are they all relevent or heavy dose or just ok for her to consume for 15 days,, please advice,,

Answered by Dr. Anantharamakrishnan (26 minutes later)

Brief Answer:
Prescription is PROPER

Detailed Answer:
Correct and state of the art
Good indeed ...
God bless her

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad