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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Better To Treat AF And High Blood Pressure?

This case concerns my wife of 79 years old height 5ft weight aprox 11stone 10 lbs. My wife started complaining of shortness of breath some 6 months ago after mild exertion in the garden and after a short rest symptoms disappeared. Up to that time my wife had been fully active and enjoyed a good fully active life with no medical condition that required any form of medication. We both put the Shortness of breath down to our ageing process. On the 20-5-2011 my wife was admitted to hospital with Shortness of breath, high blood pressure, over 180 and atrial fibrillation. Since that first admission my wife has been admitted to hospital over ten times for similar reasons but only three occasions when AF had been present. I had noted that my wife’s oxygen levels had always been recorded in the 99% range and only once required oxygen to be given. This observation may not be relevant. Echocardiogram and Pulmonary function tests have been performed but appear to have been OK. On the 28-6-2011 a coronary angiogram was conducted and the followings findings have been recorded There is moderate stenosis in a high diagonal branch with mild stenosis in the proximal LAD with calcification. The circumflex artery has minor disease only and is dominant and the right coronary artery is very small. Left ventricular function is very good. As you know she was admitted several times with chest pains but negative trop. History My wife has a history of extreme low tolerance to any form of drug or alcohol and subsequently taking medication has had extreme consequences and discomfort for her, but, she has where possible continued to take them when I myself would have not. However throughout this 8 week period my wife’s condition has not improved and still wakes up with Shortness of breath, this condition comes when she is resting at any time. During this last 8 weeks my wife’s only exercise has been going to have a wash or toilet facilities and of course this brings on shortness of breath and tightness in the chest. If I were to dial 999 every time my wife was in extreme discomfort we would be dialing several times a day. We have a first meeting with our cardiologist this week and the apparent intention is to treat my wife’s condition with medication, I am extremely concerned that maybe I am not understanding the angiogram results correctly but I cannot see how that is going to solve my wife’s shortness of breath. Therefore I seek help and guidance in understandings possible alternative procedures that may be considered.
Wed, 21 Dec 2016
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Cardiologist 's  Response
Angiography in 2011 is not having significant disease .
the main problem appears is Atrial fibrillation and hypertension.
so hypertension should be controlled and for atrial fibrillation your doctor will give some medicine to control heart rate, if heart rate is not controlled then patient will be having shortness of breath and other symptoms.
in atrial fibrillation heart beats irregularly and at fast rate. so sometimes even if heart rate is controlled then patient may have symptoms due irregular beats.
overall not to worry much , condition can be well treated. Also doctor can do certain test to know the status of blockage.
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How Better To Treat AF And High Blood Pressure?

Angiography in 2011 is not having significant disease . the main problem appears is Atrial fibrillation and hypertension. so hypertension should be controlled and for atrial fibrillation your doctor will give some medicine to control heart rate, if heart rate is not controlled then patient will be having shortness of breath and other symptoms. in atrial fibrillation heart beats irregularly and at fast rate. so sometimes even if heart rate is controlled then patient may have symptoms due irregular beats. overall not to worry much , condition can be well treated. Also doctor can do certain test to know the status of blockage.