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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Chest Pain In Case Of Congestive Heart Failure

i have had double and triple bypasses . 20 stents . i have a fib and congestive heart failure. lupus anticoagulant. diabetes type 2, diabetes and neuropathy also my hands are crippled by gout. i have hospice coming in. my children are angry because they say i am giving up. my husband is my main caregivers and is 73 both of us have had strokes and heart attacks, i am very irritable is that normal cause i sure feel guilty i sit and sleep in the same chair all day since last week the chest pains are unbearable thank you
Wed, 9 Mar 2016
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Critical Care Specialist 's  Response
HI, I UNDERSTAND THE CONCERN OF YOUR FAMILY ON THE SITUATION OF GRAVITY CLINIC YOU HAVE LIVED. AND HEART FAILURE CONGESTIVE MAY CAUSE PAIN IN THE CHEST, AS WELL AS SEVERAL OTHER ADVERSE EFFECTS AND TREATMENT DEPENDS ON PROPER FINDING AND TREAT THE CAUSE OF PAIN.

You have several diseases that can cause chest pain, such as chronic heart disease (ischemic cardiomyopathy), a possible gouty arthritis in thoracic joints, risk for pulmonary embolism because of the lupus anticoagulant.
So the answer to your question is not simple.

It is very probable that the pain you suffer should be originating in myocardial ischemia, known as angina. There are four forms of treatment for patients with angina secondary to blocked coronary arteries:

1- Clinical treatment: Made with medications that reduce metabolism and oxygen consumption of the heart muscle, as well as medications that dilate these arteries.
2- Coronary Angioplasty: It is usually used for patients with one or two obstructions in arteries and consists of placing a stent device at the site of obstructions by facilitating local blood flow.
3- Coronary artery bypass graft surgery: Used for patients with unfavorable obstructions angioplasty, with better results in the long term in relation to the placement of stents.
4- Cardiac transplantation or using a artifical heart: It is only indicated in extreme cases, when none of the above treatments are possible or effective, associated with significant worsening of cardiac function. It is the least common treatment used.

In your situation, the first attempt should be to optimize the clinical treatment with medications. However, if these pains become more intense, are not controlled with medications, you reported a compromising your quality of life, we must consider the possibility of coronary artery bypass graft surgery.

On the other hand, if your cardiologist considers your coronary anatomy is not favorable for CABG surgery, we could think of submitting you to heart transplantation or placing an artificial heart. Both heart transplantation, the use of artifical heart has a high risk of death from surgical complications and postoperative, especially in your case, with severe comorbidities that you have.

For all these reasons, I believe you need to look inmediately your cardiologist, because you have more recurrent pain and this may bring risk of sudden death for you. Also, since you can define what will be the best therapy for your case, which shies away from all that is written in the books.

Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.
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Suggest Treatment For Chest Pain In Case Of Congestive Heart Failure

HI, I UNDERSTAND THE CONCERN OF YOUR FAMILY ON THE SITUATION OF GRAVITY CLINIC YOU HAVE LIVED. AND HEART FAILURE CONGESTIVE MAY CAUSE PAIN IN THE CHEST, AS WELL AS SEVERAL OTHER ADVERSE EFFECTS AND TREATMENT DEPENDS ON PROPER FINDING AND TREAT THE CAUSE OF PAIN. You have several diseases that can cause chest pain, such as chronic heart disease (ischemic cardiomyopathy), a possible gouty arthritis in thoracic joints, risk for pulmonary embolism because of the lupus anticoagulant. So the answer to your question is not simple. It is very probable that the pain you suffer should be originating in myocardial ischemia, known as angina. There are four forms of treatment for patients with angina secondary to blocked coronary arteries: 1- Clinical treatment: Made with medications that reduce metabolism and oxygen consumption of the heart muscle, as well as medications that dilate these arteries. 2- Coronary Angioplasty: It is usually used for patients with one or two obstructions in arteries and consists of placing a stent device at the site of obstructions by facilitating local blood flow. 3- Coronary artery bypass graft surgery: Used for patients with unfavorable obstructions angioplasty, with better results in the long term in relation to the placement of stents. 4- Cardiac transplantation or using a artifical heart: It is only indicated in extreme cases, when none of the above treatments are possible or effective, associated with significant worsening of cardiac function. It is the least common treatment used. In your situation, the first attempt should be to optimize the clinical treatment with medications. However, if these pains become more intense, are not controlled with medications, you reported a compromising your quality of life, we must consider the possibility of coronary artery bypass graft surgery. On the other hand, if your cardiologist considers your coronary anatomy is not favorable for CABG surgery, we could think of submitting you to heart transplantation or placing an artificial heart. Both heart transplantation, the use of artifical heart has a high risk of death from surgical complications and postoperative, especially in your case, with severe comorbidities that you have. For all these reasons, I believe you need to look inmediately your cardiologist, because you have more recurrent pain and this may bring risk of sudden death for you. Also, since you can define what will be the best therapy for your case, which shies away from all that is written in the books. Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.