Suggest Treatment For Dizziness, Headache And Weakness Of The Arms
Also, they increased her metoprolol from 25 to 50mg, which causes her pulse rate to go in the forties. And when its time to take her lisinopril at night, usually her systolic number is high (130-150), but her diastolic number is low ( upper 40s low 50s). Is it safe for her to take lisinopril 10 mg with her distolic pressure that low?
Finally, can warfarin cause arterial calcification since it blocks vitamin k?
Thank you.
Please go through detailed description.
Detailed Answer:
Ho,
Thanks for choosing HealthcareMagic for your query,
Have seen your details.
Carotid artery bloockage is some thing very serious and is like coronary artery blockage;Just site of blockage is different.
If blockage is more then 70% then it can be managed conservatively by medicines however if blockage is more then 90% it should be stented at the earliest;Depends on reports of carotid doppler.
Yes she can wait till tuesday but should visit cardiologist in a week or two.
Chest X ray can’t see calcification in arteries it requires special test called carotid doppler.
She can take lisinopril but pulse less then 40 is termed as severe bradycardia.You could ask your primary to make dose initially to 37.5 mg per day(Not a optimal dose but just to give time to body to acclimitise) and thereafter increase it to 50 mg.
As she also had AF an anticoagulant has been therefore given to prevent chances of stroke.
No warfarin won’t cause arterial calcification.
Thanks!
Follow up.
Detailed Answer:
Hi,
Lisinopril produces a smooth, gradual blood pressure (BP) reduction in hypertensive patients without affecting heart rate or cardiovascular reflexes.It has more effect on systolic blood pressre as compared to diastolic blood pressure but as her diastolic is on lower side i would again suggest you to give half dose5 mg initially let the body adapt and then increase dose to 10 mg.Even subclinical dose of2.5 mg can also be started for few days.
Please mention the doses and timings of other drug like lasix(Directly effect B.P),Flecanide.
Because i don’t think that lisinoprel alone can cause diastolic to reach to 40 or 50(It usually work for systolic blood pressure).
Waiting,
Thanks!
No need to give lisinoprel.
Detailed Answer:
Hi again,
No i won’t suggest her to use lisinopril.
She is already on strong medications and i don’t feel thst giving lisinopril(With Diastolic at 40) at night time is a good option.
Lisinopril as such has no role in patients with A fib unless ejection fraction is low(2d echo).
No need to give lisinopril.
Flecanide drug should be monitored closely as it is by itself a proarrtthymogenic drug.
Why is she on lasix?
Regards!
Follow up answer to your query.
Detailed Answer:
Hi again,
I'd suggest holding Lisinopril for a week or two.
Once the patient is stable we can again introduce Lisinopril.
Trimetazidine could be added to 35 mg twice daily dose to help in improving cardiomyopathy and ejection fraction.
Thanks!
Answer to patients query.
Detailed Answer:
Hello again.,
Please feel free to ask whatever you want to ask i am glad to help you,
Flecanide as such does not cause bradycardia in most of the patients however mild to moderate change in pulse rate can be observed after taking flecanide.
Most likely culprit in her case is metoprolol so if there is a dose of metoprolol at night time you can hold it.
Flecanide can be given.
follow up.
Detailed Answer:
wish her a fast recovery.
Get well soon.