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What Do These Following Lab Reports Indicate?
Question: Dr, I am 56 years old non diabetic, non smoker, with hypertension tendency heart patient,My Angiogram revealed Triple Vessel Coronary Artery Disease with 99% lesion in Proximal LAD, OM1, and RCA respectively. PTCA with Stenting to LAD, OM1 & RCA was done on 20.10.2005.
Recently I did my Echocardiography which showed LVEF of 45%, so I increase my dose of Cardace 5 mg to Cardace 10 mg, is this correct?
As per reports attached herewith I am concerned about my Haemoglobin Level which is 12.9 gm/dL and also ESR 17 mm/hr. Kindly suggest some medicine for Low Level Haemoglobin.
For my sleeping disorder at night me taking Ativan 1 mg on a daily basis but not fully satisfied with the same? Is there any better medicine for peaceful sleep?
Recently I did my Echocardiography which showed LVEF of 45%, so I increase my dose of Cardace 5 mg to Cardace 10 mg, is this correct?
As per reports attached herewith I am concerned about my Haemoglobin Level which is 12.9 gm/dL and also ESR 17 mm/hr. Kindly suggest some medicine for Low Level Haemoglobin.
For my sleeping disorder at night me taking Ativan 1 mg on a daily basis but not fully satisfied with the same? Is there any better medicine for peaceful sleep?
Brief Answer:
Nothing wrong in increasing Cardace dose.
Detailed Answer:
Hi
Greetings from Dr Divakara P
Thanks for posting your query.
Well Cardace has no effect on LVEF, but increasing the dose is not wrong. Cardace has to be taken at its maximum dose for best results. So continue taking 10mg only but don't expect it to increase your LVEF.
Yes your hemoglobin is slightly low, it could be either due to Iron or Vitamin deficiency. Hence I recommend you to get Iron profile and serum vitamin B 12 levels checked and revert back to me with reports.
Depending on what deficiency I shall advise you necessary medication.
As of your ESR is concerned it is very mildly elevated and the reason for that is low hemoglobin. So no need to do anything for that , once your hemoglobin is corrected your ESR will come to normal.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Nothing wrong in increasing Cardace dose.
Detailed Answer:
Hi
Greetings from Dr Divakara P
Thanks for posting your query.
Well Cardace has no effect on LVEF, but increasing the dose is not wrong. Cardace has to be taken at its maximum dose for best results. So continue taking 10mg only but don't expect it to increase your LVEF.
Yes your hemoglobin is slightly low, it could be either due to Iron or Vitamin deficiency. Hence I recommend you to get Iron profile and serum vitamin B 12 levels checked and revert back to me with reports.
Depending on what deficiency I shall advise you necessary medication.
As of your ESR is concerned it is very mildly elevated and the reason for that is low hemoglobin. So no need to do anything for that , once your hemoglobin is corrected your ESR will come to normal.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Dr,
My USG Of KUB revealed Prostate weighing 34 gms for which I am taking Veltam Plus tablet once daily at night along with Ativan for Sleep Disorder. Is this correct medicines. I am getting addicted to Ativan without which I cant sleep properly. Is daily consumption of Ativan Tablet harmful?
My USG Of KUB revealed Prostate weighing 34 gms for which I am taking Veltam Plus tablet once daily at night along with Ativan for Sleep Disorder. Is this correct medicines. I am getting addicted to Ativan without which I cant sleep properly. Is daily consumption of Ativan Tablet harmful?
Brief Answer:
Reduce taking Ativan
Detailed Answer:
Hi
Veltam for your prostrate is fine but Ativan should not be taken daily as its habit forming. In fact any medication for sleeplessness is habit forming. Long term use of Ativan can cause dependency and slowness of mind.
I advise you to reduce taking Ativan , because stopping all of a sudden can cause rebound sleeplessness.
Avoid drinking coffee or tea during evening or night, have light dinner and go for a walk after your dinner. Go to bed early and avoid watching TV or XXXXXXX once you go to bed.
You can read a book when you go to bed, with these measures you may get good sleep . In that case you can further reduce taking Ativan and eventually stop. Kindly follow this advise.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Reduce taking Ativan
Detailed Answer:
Hi
Veltam for your prostrate is fine but Ativan should not be taken daily as its habit forming. In fact any medication for sleeplessness is habit forming. Long term use of Ativan can cause dependency and slowness of mind.
I advise you to reduce taking Ativan , because stopping all of a sudden can cause rebound sleeplessness.
Avoid drinking coffee or tea during evening or night, have light dinner and go for a walk after your dinner. Go to bed early and avoid watching TV or XXXXXXX once you go to bed.
You can read a book when you go to bed, with these measures you may get good sleep . In that case you can further reduce taking Ativan and eventually stop. Kindly follow this advise.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr,
I am also having Swallowing problem particularly in the full portion from end of legs till start of leg fingers? what can be the reason for the same? Is it due to Low % of LVEF. And what medicine can i take for the same along with all my heart medicines?
I am also having Swallowing problem particularly in the full portion from end of legs till start of leg fingers? what can be the reason for the same? Is it due to Low % of LVEF. And what medicine can i take for the same along with all my heart medicines?
Brief Answer:
Yes it could be due to low LVEF
Detailed Answer:
Hi
I think you meant swelling of the foot , correct me if I am wrong.
Yes it can be due to low LVEF but 2 other conditions that also need to be checked if your protein levels in your blood and your kidney function.
In that regard I advise you to get Serum Albumin and serum creatinine test and revert back.
Also I would recommend you to take Cardace H instead of Cardace. This H in Cardace H will resolve your foot swelling.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Yes it could be due to low LVEF
Detailed Answer:
Hi
I think you meant swelling of the foot , correct me if I am wrong.
Yes it can be due to low LVEF but 2 other conditions that also need to be checked if your protein levels in your blood and your kidney function.
In that regard I advise you to get Serum Albumin and serum creatinine test and revert back.
Also I would recommend you to take Cardace H instead of Cardace. This H in Cardace H will resolve your foot swelling.
Hope this information was useful to you.
Any clarification feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr.
Recently I did my LFT Test which revealed Serum Albumin as 4.3g/dL, and Serum Albumin:Globulin as 1.26, Serum ALT/SGPT- 22 U/L, Serum AST/SGOT - 21 U/L
Serum Alkaline Phosphatase - 72 U/L.
I guess all these results are in normal reference? Do i also need to check my Serum Creatinine or my swelling would disappear gradually after i start intake of Cardace H 10 mg?
Recently I did my LFT Test which revealed Serum Albumin as 4.3g/dL, and Serum Albumin:Globulin as 1.26, Serum ALT/SGPT- 22 U/L, Serum AST/SGOT - 21 U/L
Serum Alkaline Phosphatase - 72 U/L.
I guess all these results are in normal reference? Do i also need to check my Serum Creatinine or my swelling would disappear gradually after i start intake of Cardace H 10 mg?
Brief Answer:
Get Serum Creatinine test done.
Detailed Answer:
HI
See low LVEF explains your lower limb swelling , but kidney problem also can cause lower limb swelling.
So I advised you to get checked with Serum Creatinine so that a complete evaluation happens in you.
Kindly get it done.
Yes your LFT report is fine.
Regards.
Get Serum Creatinine test done.
Detailed Answer:
HI
See low LVEF explains your lower limb swelling , but kidney problem also can cause lower limb swelling.
So I advised you to get checked with Serum Creatinine so that a complete evaluation happens in you.
Kindly get it done.
Yes your LFT report is fine.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dr Divakara,
Greetings of the Day!
As per your advice I did my Serum Creatinine Test, Result of which was 1.45 mg/dL.
As already told by yourself that my LFT report is fine, now can you please advise me medicine for my lower limb swelling apart from that I am also having problem of Frequent Urination specially late at night say after 10 p.m. and there is very less or almost no tendency of urine during afternoon times.
I trust your advice a lot hope you would guide me in this matter.
Greetings of the Day!
As per your advice I did my Serum Creatinine Test, Result of which was 1.45 mg/dL.
As already told by yourself that my LFT report is fine, now can you please advise me medicine for my lower limb swelling apart from that I am also having problem of Frequent Urination specially late at night say after 10 p.m. and there is very less or almost no tendency of urine during afternoon times.
I trust your advice a lot hope you would guide me in this matter.
Brief Answer:
Frequent urination could be due to Prostrate enlargement.
Detailed Answer:
HI
Thanks for your words.
So your creatinine is slightly on the higher side ( 1.4 is normal ). But that is not the cause for your leg swelling, but you need to avoid ( in future ) any medications that can cause damage to kidneys ( especially Pain killers ).
For reduction of your leg swelling , if the swelling is very much significant you can take Torsemide every morning , for a week . But you need to take this in consultation with your doctor as there can occur mild reduction in blood pressure after starting this medicine.
But if the swelling is mild then no need for Torsemide , just changing to Cardace H itself will bring down your swelling.
Coming to your frequent urination , it could be due to prostrate enlargement , you can take Urimax-D every night . Get a prescription from your doctor and also get Ultrasound abdomen pelvis scan to confirm the diagnosis.
Hope this information was useful to you.
Any clarification feel free to ask .
Regards.
Frequent urination could be due to Prostrate enlargement.
Detailed Answer:
HI
Thanks for your words.
So your creatinine is slightly on the higher side ( 1.4 is normal ). But that is not the cause for your leg swelling, but you need to avoid ( in future ) any medications that can cause damage to kidneys ( especially Pain killers ).
For reduction of your leg swelling , if the swelling is very much significant you can take Torsemide every morning , for a week . But you need to take this in consultation with your doctor as there can occur mild reduction in blood pressure after starting this medicine.
But if the swelling is mild then no need for Torsemide , just changing to Cardace H itself will bring down your swelling.
Coming to your frequent urination , it could be due to prostrate enlargement , you can take Urimax-D every night . Get a prescription from your doctor and also get Ultrasound abdomen pelvis scan to confirm the diagnosis.
Hope this information was useful to you.
Any clarification feel free to ask .
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Divakara,
Greetings of the day! I am really thankful to you for your great advice. This time I need to ask you something for my wife, She is 55 years old non diabetic, hypertension tendency heart patient done with Angioplasty in the year 2007 with implant of one stent, recently her Echo Cardiogram revealed LEVF as low as 45%, whereas her ECG was of impression within normal limits. I understand once heart attack has taken place ECG cant come to normal at any point of time- isn't it true?
At present she has taking Seloken XL 50 mg, Cardace 10 mg Ecosprin Gold 150/20 on a daily basis plus Atocor 10 mg and Dytor 20 mg twice a week.
The day she is taking Atocor and Dytor she is facing a problem of frequent urination? How can this be solved? She is having a sedentary life style so she has shortness of breath and unable to walk at a slow speed also even 1-2 km also.
I get scared due to her shortness of breath sometimes, what remedies and precautions would you recommend for her?
Greetings of the day! I am really thankful to you for your great advice. This time I need to ask you something for my wife, She is 55 years old non diabetic, hypertension tendency heart patient done with Angioplasty in the year 2007 with implant of one stent, recently her Echo Cardiogram revealed LEVF as low as 45%, whereas her ECG was of impression within normal limits. I understand once heart attack has taken place ECG cant come to normal at any point of time- isn't it true?
At present she has taking Seloken XL 50 mg, Cardace 10 mg Ecosprin Gold 150/20 on a daily basis plus Atocor 10 mg and Dytor 20 mg twice a week.
The day she is taking Atocor and Dytor she is facing a problem of frequent urination? How can this be solved? She is having a sedentary life style so she has shortness of breath and unable to walk at a slow speed also even 1-2 km also.
I get scared due to her shortness of breath sometimes, what remedies and precautions would you recommend for her?
Brief Answer:
ECG can normalize.
Detailed Answer:
HI
Greetings from Dr.Divakara.P
Went through your query. In address this in step by step.
1. Problem of frequent urination : This is clearly a side effect ( in fact it is the effect ) of Dytor ( not Atocor ). If frequent urination is bothering her then she can reduce the dose to 10 mg with consultation with her doctor.
The reason why Dytor is being given to her is due to Low LVEF there is a possibility that fluid might get accumulated in the lungs and thus cause breathlessness. So before reducing the dose of Dytor her doctor will make sure by examination that there is no fluid collection in her lungs , only then Dytor dose can be reduced.
Also what time of the day she takes Dytor ? It should be taken in the morning only.
Her LVEF though low, is not so low enough to cause shortness of breath while walking at slow pace. We need to evaluate why she feels so short of breath while walking.
When was her recent ECHO done ?
Also get Complete Hemogram test to check her Hemoglobin status ?
She needs to start walking at whatever pace she is comfortable . Make sure she walks for at least 3-5 minutes 2-3 times a day. let her gradually ( over a period of weeks ) increase the duration of walking. She should never over strain herself.
She need to reduce her fluid intake to 1.2-1.5 litres per day. Fluid includes water, milk, coffee, tea, juice soup etc. All combined should not cross 1.5 litre per day.
In addition I recommend yearly Influenza vaccine and Once in Lifetime Pneumococcal vaccine for her.
Regarding the ECG coming to normal -- It can happen if the stent placed is working well and the blood flow to the heart is fine.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
ECG can normalize.
Detailed Answer:
HI
Greetings from Dr.Divakara.P
Went through your query. In address this in step by step.
1. Problem of frequent urination : This is clearly a side effect ( in fact it is the effect ) of Dytor ( not Atocor ). If frequent urination is bothering her then she can reduce the dose to 10 mg with consultation with her doctor.
The reason why Dytor is being given to her is due to Low LVEF there is a possibility that fluid might get accumulated in the lungs and thus cause breathlessness. So before reducing the dose of Dytor her doctor will make sure by examination that there is no fluid collection in her lungs , only then Dytor dose can be reduced.
Also what time of the day she takes Dytor ? It should be taken in the morning only.
Her LVEF though low, is not so low enough to cause shortness of breath while walking at slow pace. We need to evaluate why she feels so short of breath while walking.
When was her recent ECHO done ?
Also get Complete Hemogram test to check her Hemoglobin status ?
She needs to start walking at whatever pace she is comfortable . Make sure she walks for at least 3-5 minutes 2-3 times a day. let her gradually ( over a period of weeks ) increase the duration of walking. She should never over strain herself.
She need to reduce her fluid intake to 1.2-1.5 litres per day. Fluid includes water, milk, coffee, tea, juice soup etc. All combined should not cross 1.5 litre per day.
In addition I recommend yearly Influenza vaccine and Once in Lifetime Pneumococcal vaccine for her.
Regarding the ECG coming to normal -- It can happen if the stent placed is working well and the blood flow to the heart is fine.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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