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What do these ECG, cardiac profile and PFT reports indicate?

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
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Answered by

Pulmonologist
Practicing since : 2008
Answered : 13023 Questions
Question
Hello Doctor,

Need your expert advice here,request you to please guide me on this and let me know the further process

Medical history
1.     Bronchitis asthma
2.     Thalassemia Minor
3.     Severe Iron deficiency anemia
4.     Shoulder pain , muscle pain in shoulder has supraspinatus tear
Recently diagnosed Blood pressure and has been put on blood pressure tablet from past 5 days
Tablet – stamlo 2.5 mg twice a day
She has been having high pulse rate of 100 at resting and at times goes till 110 also.

Current medication
1.     Stamlo 2.5 --- Blood pressure
2.     Rozavel F --- cholesterol
3.     Budecort 200 MCG - Asthma
4.     Movon CR and Mahagaba M 75 and Tramazac PD for Suprasinatus tear in shoulder
5.     Vitamins
•     Evion LC
•     RB tone
•     Folvite
•     Uprise D 360

Current problem :
My mother has been diagnosed with Bronchitis asthma in 2015, she use to take sereflo 125
But she stopped taking inhaler from past 7 – 8 months as on taking inhaler she was feeling high palpitations
Recently she was getting little breathlessness and was snoring a lot in the night with cough and as an observer I could observe her sleeping patterns like she snors and then skips 2 or 3 breaths the noise goes away and then again snoring starts .
Basis the PFT report which we did recently doctor asked to continue the inhaler

But my mom felt very high palpitations for around 3 hours after she took the puff and we had to rush to the casualty yesterday night becoz her pulse went up to 120 and palpitations were not stopping In the emergency, docs did the Cardiac profile test , her pulse came as 118 which the doc said its high but he said may be it is due to the puff the palpitations have started
The doctor changed the inhaler today to Budecort 200mcg
Current complain is high pulse , moderate BP even after taking BP tablet , and short breath
For pulse the doctor has prescribed Angizem CD today which she has not taken till now .
I am concerned, that with asthma inhaler and montair LC tablet for cough which is an anti-asthama tablet can we take the calcium blocker tablet ( angizem CD) . Is that ok?
and can you please review the ECG reports and Eco reports due to see any ECG changes ? and is the 2D Echo report alarming?
And the HGT which we did yesterday is that high value of 173 is high?
WE had done her Diabaties test which came to be normal but yesterday the HGT was 173 is that high?

Advice required on the above problem Attached reports
Current ECG
Cardiac profile
Latest PFT report


Fri, 18 May 2018 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 57 minutes later
Brief Answer:
Yes, you can give her calcium channel blocker.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
Ecg report on 20th Dec 1 is not normal.
It shows some ST T changes in inferior leads.
But these kind of changes are seen with tachycardia.
So 2d echo should be done.
Sorry to say but there is no 2d echo report attached.
So please attach 2d echo report if done.
Regarding calcium channel blocker (CCB) you can definitely give her. No need to worry for asthma drugs and CCB interactions. These are safe drugs with CCB.
Regarding Diabetes query, better to get done HbA1C level. If this is above 7,possibility of diabetes is high.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by
 
Follow-up: What do these ECG, cardiac profile and PFT reports indicate? 36 minutes later
Hello doc

Can you please tell me how bad is the asthama as she has cough also in the night and can it be corrected via budecort. And due you think high palpiatation and pulse rate had increaed becoz of sereflo inhaler??

Also i am attaching the echo report done 25 dats back before this episode of high pulse bp and palpitation can you please review and advice.

And lastly are these changes in the 20th dec ecg something major to worry about with regards to heart attack or blockages or valve problem

Please advice.
 
 
Answered by Dr. Kaushal Bhavsar 8 hours later
Brief Answer:
2d echo is normal.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the 2d echo report.
It is normal. So no need to worry for major cardiac diseases like heart attack or valve defects.
Since her palpitations are with seroflo only, possibility of salmeterol related palpitations is more likely.
Does she improve with budecort in palpitations?
Her PFT report is not bad. So no need to worry for severe asthma.
Please let me know
1. Is she having edema feet?
2. Is coughing more in supine position in night?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by
 
Follow-up: What do these ECG, cardiac profile and PFT reports indicate? 1 hour later
Hello Doc

She does not have swollen feet or edema feet
And coughing is the same while she she is in straight position or on the side coughing is not that bad but morning cough is there

Also she doe not sleep for the enture night like few nights she is completely up like whole night not getting sleep and at times she gets few hours of sleep but she snors a lot during that time and looks like she skips 2 or 3 breaths and it goes silent then again snoring starts

Also i have a question, till now from past 5 days she has been taking stamlo 2.5 for blood ptessure and nothing for pulse rate. But since pulse is always around 100 we got worried and went to the doc he said stop stamlo and start angizem cd 90 it wikk work for bith pulse and bp.

My mom was nvr a blood presuree csndidate since 5 days she has starred medication my question is shud she continue with stamlo 2.5 twice a day or stop stamlo and take angizem cd 90 as her pulse rate now also is 100 but bp under control

Please guide me on this

Also, her palpiation is better witg bldecort not like sereflo
Also one very imp thing i am atatching the echi report done on 20th dec 2 dsys back can u please compare with the one done 25 days back which i had attached earlier and let me know if there are changes

Also please reply and advice at the earliest as she has to tske her morning tablets whether she shud take stamlo only or change to angizem
 
 
Answered by Dr. Kaushal Bhavsar 4 hours later
Brief Answer:
No need to worry much. Both echo reports are almost similar.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through new attachments.
Both 2d echo reports are same.
No need to worry for this.
And in my opinion, she should take CCB and stop Stamlo.
Monitor her blood pressure and pulse rate daily in the morning for 5 days.
If blood pressure and pulse rate are good then continue with CCB only.
She can take montair LC. No need to worry for palpitations with montair LC.
This will supress cough.
The way you have described her sleep, we should definitely rule out Obstructive sleep apnea (OSA).
So please let me know her height and weight so that I can guide you better.
I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by
 
Follow-up: What do these ECG, cardiac profile and PFT reports indicate? 1 hour later
Thanks for the advice doctor.

Weight 68.4
Height 5'2 154cms
 
 
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
We should definitely look for OSA.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I have calculated her BMI and it comes around 29.
So she is pre obese.
She snores and having apnea episodes (on the basis of your description).
So we should definitely rule out OSA in her case.
Please let me know
1. Is she complaining about morning headache?
2. Is she complaining about excessive day time sleepiness?
3. Is she having lack of concentration or irritable behavior?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by
 
Follow-up: What do these ECG, cardiac profile and PFT reports indicate? 3 hours later
Hello doc

She is having lack of sleep irritable behaviour no headaches as such

As u are suggesting sleep study but as she doesnt get sleep in the night so how the sleep study test will come normal. Will docs give sleeing pill for that particular night?

Also I am attaching one report can you please examine the same and let me know what it means it is linked with pft report.

Also one last question on the CCB medicine
Now her bp is little under control 135/80 and pulse is around 90. Can she continue stamlo and not take CCB??? Kindly advice please
 
 
Answered by Dr. Kaushal Bhavsar 11 hours later
Brief Answer:
No, sleeping pills are not used for sleep study.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No, sleeping pills are not used for sleep study.
I have gone through the PFT graphs.
They are identical with PFT values. So no need to worry for severe asthma. It is in mild range.
Well with these values (blood pressure and pulse), you can continue with Stamlo.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by
 
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