Hi,

Thanks for sharing your health concerns.

The pain you refer to sounds muskuloskeletal in nature, and could be related to a muscle strain, sprain, articular problem such osteoarthritis, etc does not sound cardiac in nature as it is affected by movement. Your orthopedic doctor can do a focused examination and provide a definite diagnosis. I would encourage you talk to him before taking any pain medications given your heart condition.

In terms of constipation, the most common cause is functional related to suboptimal fiber and fluid intake but other systemic processes such as hypothyroidism, diabetes or irritable bowel syndrome. You might start by increasing fiber intake and talking to your provider about laxative options. I encourage you to work on this constipation issue since you are on double antiplatelet therapy and bowel strain could increase risks of gastrointestinal bleeding.

Hope this useful wish you the best health

Dr Brenes salazar
Mayo clinic mn

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It seems that both your fluid and fiber intake are adequate. I would consider using a stool softener or soft laxative daily. Your primary physician can guide you through both options, decide dosage and monitor response.

Hope this is helpful. Wish you the best health.

Dr Brenes Salazar, MD

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Thanks for your follow up questions; I think it is quite reasonable to mention those episodes of exertional discomfort to your cardiologist, since they seem different from the shoulder discomfort you experience with stretching. He may then decide if further testing is required. As far as the constipation issue, it sounds quite severe and you should evaluate the laxatives/stool softeners with the guidance of your primary physician, since if no response is seen then some abdominal imaging might be needed to rule out a mechanical cause of persistent constipation.

Hope this is useful; wish you the best health.

Dr Brenes Salazar MD

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