Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

140 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Taking medicine for hypertension and high cholesterol. Diagnosed with hyponatremia. Risk of heart disease?

Answered by
Dr.
Dr. Anil Grover

Cardiologist

Practicing since :1981

Answered : 922 Questions

default
Posted on Fri, 15 Feb 2013 in Hypertension and Heart Disease
Question: Hi, my dad is 70 years old.He doesn't have any history of heart disease.He was on hypertension cholesterol medications.On one fine day he got sum uncomfortable feeling in chest without pain and later on some sweating with vomiting feeling. ..we immediately went to the emergency...Der day saw some ischemia changes and trop t came positive with value of 1.17ng/ml. His 2d echo was normal and exactly d same as of 2years before. Diagnosed with hyponatremia...sodium levels of 114...was on blood thinners and salt for a week and we were ready for the discharge. .doctor suggested us for angiography but my dad's hb fell from 10.5 to 8.8 and doctor said that Der is a Need of bloodtransfusion bbefore angiography. ..1unit of blood was given and after around 2hrs when 220ml was transfusion,he ddeveloped shortness of breath shivering wheezing and he was shifted to emergency again.were told that it could either due to blood reaction or some CAD problem in heart...day were also saying that heart entered into Lleft ventricular failure...bp and pulse rises to extreme. .pulmonary edema also developed as a result..he remained in ICU for 4 days n doctors told that he is responding well to the treatment by output of negative 3 litres and now doctors said that his chest is clear n we can be relieved from d hospital. MY question is whether that episode would have impacted my dad's heart or that was a temporary situation and will Der be any changes in his 2d echo now .he is having cough as of now at regular intervals.angiography shows left main coronary artery normal and other small arteries show some blockage which have been recommended to improve by medications
doctor
Answered by Dr. Anil Grover 6 hours later
Dear XXXXXXX
Thanks for writing in.
I am a qualified and certified cardiologist. I read your well written summary of the situation. My feelings are because:
1. Your dad had hypertension and high cholesterol (Both of which are risk factors for coronary artery disease. There was justification in doing the angiogrphy. It has been reported having insignificant disease .
2. Left Ventricular Hypertrophy was detected by echocardiography is a common consequence of hypertension.
3. The, assumption of having blood reaction appear justified because while cross matching it is not practical to test for each component blood to be matching.
4. Therefore, my provisional opinion to your question about persitence of changes in echocardiographic examination is that: yes some changes like left ventricular hypertrophy will persist. and
5. As to the cause for shortness of breath, when there is left ventricular hypertrophy heart becomes stiff and there is resistance to filling it during circulation. There is some back flow in the veins carrying oxygenated blood from lungs to heart, resulting in shortness of breath.
6. In my opinion the acute illness he suffered was a temporary phenomenon because of anemia and reaction to blood. He would be better when his hemoglobin comes up and his hypertension is kept under control. Even diastolic dysfunction mentioned above is a treatable condition.
If you can copy the report and upload an EkG along with his present height and weight and lipid profile with list of drugs he has been advised. I would be wiser in telling this with more certainty. Looking forward to get a mail from you. Good luck.
Regards and Happy Republic Day,

Dr Anil Grover
MD (Medicine) DM(Cardiology)
Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Anil Grover 7 hours later
sir I m not able to upload any report as sizes are more than 2mb. ..well my only concern is that his ejection fraction in last two 2d echos was 60% and all other function were normal....but after this episode of circulatory overload will his structure wud have been impacted or will Der be any change in ejection fraction?
doctor
Answered by Dr. Anil Grover 1 hour later
Thanks for writing back.
In Diastolic dysfunction (without effecting the pumping action that is systolic function) ejection fraction is normal (60%) is normal. So, except that there is no mention of E wave and A wave as cm/seconds (which you can send me) your echo appears normal. So there does not appear to any permanent damage to heart.
You can upload the jpeg images of EKG and send those to my personal email address YYYY@YYYY . There is no problem in uploading upto 10 MB data in one mail. Good Luck

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Anil Grover 3 hours later
Sir I have sent 3 ecgs done during admission, after one day and immediately after blood transfusion reaction.Also Sir my previous question was that as my dad's 2d echo was normal. ..will this circulatory overload done by blood transfusion will make any permanent changes on my dad's heart...if we will do 2d echo now...will d results be same as that of previous ones or dis entire episode of blood transfusion induced circulatory overload which has made my dad heart to enter into LVF will cause any permanent changes....
doctor
Answered by Dr. Anil Grover 7 hours later
Thanks for writing back. I appreciate the effort you have taken to send me scanned EKGs and Echo report. I find that you are under care of Dr XXXXXXX S Wander. He is a friend and I can assure you he is the best cardiologist in Ludhiana: one of the country's best.
About EKG review I have written before. Your father's echocardiography does show effects (not the damage) because of hypertension. I am pretty certain echo done now after the event which led to blood transfusion reaction, will be more or less same. I would strongly urge you to continue your treatment under Dr Wander. Good Luck.
Thanks for using health care magic. If you have further query you can write to me (please ask a direct question) I will be most happy to answer your question.
Regards
Dr Anil Grover,
Cardiologist & Internist
M.B.;B.S, M.D. (Internal Medicine) D.M(Cardiology)
YYYY@YYYY
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Anil Grover 4 hours later
Yes Sir, he is like God for us.He has saved my dad's life.Last night I was able to speak to him and he has cleared all my doubts.Thanks to you as well.
doctor
Answered by Dr. Anil Grover 1 hour later
Thanks for your kind words.
Kindly close the query with stars and remarks, it was a pleasure interacting with you.

Best Wishes

Anil Grover

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

The User accepted the expert's answer

Share on

Recent questions on  Cardiomegaly

doctor1 MD

conclusion of a regular medical check is that I need an echocardigraphic evaluation. examining physician says chest X-ray indicated moderate cardiomegaly. electrocardiogram indicated inferior wall ischemia. my blood pressure was 120/80. he thought this may be accounting for the moderate cardiomegaly and the inferior wall ischemia. i exercise regularly (walk 3 to 6 km three times a week; 1 hour gym 2 times a week). enjoy 3 glasses of beer after walking exercise; or red wine with food after gym. do not smoke. weighing 85 kg (recently reduced from 87kg; usually keep weight 82-85kg). 174 cm tall.

doctor1 MD

I was severely constipated 2 days ago and i was pushing for hours trying to get it out cause the pain was so bad. I did finally poop but now my whole body hurts kind of where both kidneys are and my stomach. i cant even speak loudly or it hurts. could it be muscles cause i was straining for so long? i am female 32 years old and weigh 245 lbs. and have left ventricular hypertrophy.

doctor1 MD

I have two leaky heart valves and mild cardiomegaly, along with Fibromyalgia and Chronic fatigue. I did have Sleep Apenia, but I lost some weight. So I am told I no longer have the sleep problem. My cardiologist tells me my heart issues are not that serious and I should not worry and to just lose a little more weight and keep my BP under control ( I am on med for that). My question is the fact that I remain constantly tired and sleepy, so much to the point I can barely work my full time job. I can t even bathe myself at times. I have no energy to do basic stuff like my house work and I am afraid to drive for falling asleep. I have Asthma as well, but none of the treatments for the Asthma is working or has ever worked for me. To make matters worse I have problems breathing all the time, and constant pain in my chest on the left side, fluttering from time to time, stomach bloated. My cardiologist insist that it is not my heart that is causing these problems. When I go to places like Walmart I can no longer walk around the store I must ride one of the scooters. He insist it is the Fibromyalgia causing these problems or the Asthma. Yet the ashtma medication does not healp. He also think it maybe the Acid reflex, so I see a Castro fir that. I don t want to wait until things get worse and then I find out later that maybe my heart problems were more serious than he or I thought and not treated earlier on. I had a aunt that had heart problems and it was not treated in a timely manner and she passed away. Also have a good friend that has the same problems and her first doctor failed to treat her problems and her second doctor jumped right on it, right away and was so upset that her problem was not addressed earlier. She has since had surgery and many complications as a result of not having her problem treated early on. Although she is 10 years older than I. I will turn 58 this Saturday. I just want to feel better, I have no life outside of work. I go to work and barley make it through the day and come home and try to sleep or just sit and read and write and watch TV. I have attempted to excercise, but my energy level will not allow it. I am now weighing 171, I have lost 10 lbs. I even had my tonsils and uvala removed to health with the breathing. It did not help much. I do not go anywhere, because I am just to tired and not feeling well. I attempt to rest to get my strenght back to return to work on Monday. Today is Monday and I am still not feeling well enough to go to work. I am giving a lot of thought to changing my cardiologist. First he told me my heart was not enlarged and then he told me it was. Then he told me I didn t have any blockage and when I continued to complain about the chest discomfort , he admitted I did have a slight blockage (20%) and it was not that bad.Thanks for your time.

doctor1 MD

I was told several years ago (three or so) that I had a very small hemangioma on my T5 vertebrae. It was an incidental finding and I was told it would probably never grow or do anything. I am just curious if it's visible in any of these xrays. I...

doctor1 MD

i m 20 year old..and i have hypertension my blood pressure remains 150/100.. my current medicines are atenolol 50mg ( 2 times a day
amlodipine 5mg ( 2 times a day turosamide 5mg ( 1 times a day

all blood test ,renal test are done and are normal
ECG shows LVH
ECHO SHOWS LEFT VENTRICULAR WALL THICKNESS IS 10.4MM
my blood pressure is not coming down ...answer me what to do

doctor1 MD

Female aged 67 lung xray show enlarged heart and bnp is 118. Is this concerning ?

doctor1 MD

Hi Doctor my mother 56 years of age is suffering from congestion in chest and short of breath ... today doctor has advised following medicine and blood test . attaching report and medicine he has suggested. is treatment ok. please advise.