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High BP, thyroid, have pain near heart, abnormal TMT reports, advised angiography, prescribed medicines. Suggestion for proper treatment?

My mom is 45 yrs old. She is having a pain near her heart . One of the doctor suggested us to do the two tests - one is TMT ( stress test) and 2D Eco test. He told us that TMT reports are not normal. and told to proceed with An-geography. We consulted one Cardiologist , he said that your mother is fine not to worry. Previous doctor gave the following medicines - 1. Ecospin Av (75) 2. Nexito plus 3. Eldeent 2C 4. Remipress -L Cardiologist suggested following medicines - 1. Tetan Beta 50MG 2. Rekool 20 MG 3. Retoz 90 MG My mom is having High BP problem and thyroxoid problem. I dont understand whom to follow.. Which medicines to take and should we proceed with an-geography? Plz reply
Wed, 26 Sep 2012
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Internal Medicine Specialist 's  Response
Welcome to HCM
Your mother has Hypertension,Thyroid problem?what is it Hyper or hypothyroid is she taking medicines for it. As TMT test is positive this is possible that her pain is anginal ? so medicine must be taken by her and in the meantime you can decide about angiography which is goldstandard for knowing the state of coronary arteries,if mild disease then she may continue medical therapy if significant obstruction exist then it would need a Angioplasty alog with a placement of stent.
Yes going through angiography and angioplasty is expensive but if angina is there that is the way to go about the management.
Short of that medical therapy must continue.
Good luck
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Emergency Medicine Specialist Dr. Sujjalaxmi Bharali's  Response
First of all to opine on the two sets of treatment without knowing the exact TMT report would not be wise.
Rather I would suggest you go ahead with the coronary angiography done if your cardiologist suggests after seeing the TMT report. Otherwise non specific changes in TMT does not need to be taken up immediately for coronary angiogram. But prior to that get the renal profile ( serum creatinine) done.
As for the treatmment:
Continue Ecosprin AV 75 mg
Both Ramipress XL and Tetan beta are anti hypertensives. You can continue either of the two. Tetan beta would be better.
Rekool 20 mg is OK for a short period.
I am not convinced regarding retoz for pain management. In fact when in pain may take sorbitrate 5mg .
I also do not know why statins were missed .
Stop nexito plus and eldeent in case you are taking.
I know in case you follow mine you would not be able to visit either for follow up!!!
I suggest you proceed for the angiography so that once and for all we can come to a diagnosis and decide regarding the further management without any confusion.
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