Question: Hello doc,

AS I have already discussed the case of my Father with you that he had gone throiugh an acute MI and angioplasty done in November mid , I am attching all the reports for your reference

I had 2 questions now
1. His pulsse rate is always on the lower side like morning it is XXXXXXX 68 - 69 and as the day goes it reaches 59 - 60 also. he has been taking ivabrad as prescribed 2 times a day , Soo I want to know is that any sign of heart episode that the pulse rate is slow or that is fine ?
2. my dad is currently having pain in the ribs right side and had been taking lanol er tablet for 2 days but still the pain has not subsided can you please advice and help what could be the reason, is this something related to heart?

Brief history
Medical history : hypertension from past 9 years and acidity problem
Age : 59 years
Sex : Male
My Father got an acute MI on 16th November, prior to this from past 10 days he was suffering from low blood pressure and our family doc asked him to stop the BP tablet for few days . on 16th nov since morning 5 am he got high acidity and chest pain but we thought it was acidity we gave rantac and other home remedies but he started sweating and got severe pain in the chest. We took him to the nearby hospital and the doctor immediately did the angiography and found the main coronary artery was 100% blocked which had to be stented immediately but he said its very risky as you have reached late the damage has already happened. He processed with the angioplasty there were total 3 blockages on the left side 2 were done via balloon and the 100% blockage one was stented .
Post the surgery on the next day my dad started feeling high acidity , big burps , heaviness in the chest and his heart rate was very high. From then we were in the hospital till 25th Nov till his heart rate and BP and other things got normal. He had little breathlessness also.

Post returning home on 25th , my dad felt very weak at home and again on 2nd dec we got readmitted for Low blood pressure as my dad fainted at home and we checked the bp was very low and hence we got him to the hospital . Doctors admitted him to the ICCU and started giving fluids to bring up his BP

Doctors said , low BP was due to dehydration as my father had gone for motions thrice that particular morning and since the intake of fluids is restricted to 1.5 ltrs XXXXXXX
Previous medication when we got discharged on 25th Nov : Cardivas, Ivabrad, ecosprin, brillinta, restyl for sleep and now since my dad complained of breathlessness they have changed the medication and now they have discontinued cardivas completely and increased the dose of ivabrad and asked to stop brillinta and take prax 10mg

Hello Doc,

Lanol ER has Paracetamol - 650 MG as the main ingredient . Also what could be the reason of pain in the ribs ?
In the case of pulse rate, the doc who did the angioplasty did not suggest to stop
Or reduce the ivabrad even after we told him
That the pulse rate is aroujd 59 and 60.

But he did reduce the dose and started taking half tablet in the night.Soo what could be the reason if the heart pumping too low. Is it the case if ICD?