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my father Sisir debbarma is suffering with cardiac problem that is estimic change and ventricular enlargement of heart what shall i do now
there is no proper health facility in my state

Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Thank you for your query at DoctorSpring.com
I understand your concern.
I have seen all the reports and have reviewed his X RAY and ECG findings. The ischaemic change is age related and with adequate diet control and cholesterol control, it will not cause any harm. He needs to make sure that his weight is normal. Mild walking around 30-45 minutes per day will also be helpful.
The ventricle enlargement again is age related, and can be due to the hypertension that he had in the past, or can also be due to anemia. Whenever our heart has to work harder to pump blood secondary to causes like cardiomyopathy, or anemia, or hypertension, or high cholesterol, the chambers ( ventricle ) enlarges to pump more blood effectively. Since your dad had both anemia and hypertension, the ventricle has enlarged.
With a good diet control, mild walking and Stator-80, his heart function will be adequate. Also his BP is under control now and all other parameters are also under normal limits. So that is an encouraging sign.
Right now he needs no further intervention. Get a repeat ECG in 3 months. If there are any complaints like chest pain or shortness of breath, then Treadmill Test can be done.
Hope this was helpful,

Patient replied :

But we have gone to a hospital also to a cardiologist there they asked to do angiogram because they have a doubt of blockage in aortic subdivision due to which the istimic change took place and they were telling about doing angioplastid as furthur treatment
how long should he continue stator80??

Expert:  Dr. Vivek Mahajan replied 3 Days.

I initially did not receive his echo report.
Now i reviewed and it shows that he has grade 2 diastolic dysfunction.
That can also be due to hypertension for the last 10 years.
Angioplasty will only be required if he has any current symptoms as of now.
Can you tell me what are his present symptoms? Like does he have any shortness of breath? Or any orthopnoea, that is more shortness of breath after laying down? Or any chest pain?
In absence of any symptoms angioplasty won't be required as of now. Also can you tell me the medicines he is taking for his hypertension?

Patient replied :

he donot suffer from shortness of breath
but during season change time like november december january february he have to use asthalin inhaler due to some breathing problem only at that time
he had sevior pain in his upper abdomen in forth week of august so we have admited him to hospital
in hospital they gave drotin ds injection but still it was not cured after that doctor gave all that conclusion that he have such problem in heart
he takes STAMLO-5 for his hypertension

Expert:  Dr. Vivek Mahajan replied 2 Days.

Did you get an ultrasound when he complained of the abdominal pain?
It is possible that due to right ventricle enlargement, the liver may get enlarged. And that can cause abdominal pain.
STAMLO-5 is the right medicine which will help his dysfunction. Also his BP is under control and that means he is tolerating the drug well.
How is he currently? If he does not have any symptoms, currently angiography is not required.
Let me explain when he will need angioplasty.
Due to long standing hypertension, as i said earlier, he had developed enlarged heart chambers. That is leading to slight dysfunction in the heart. You have to watch out for symptoms such as :
1) Shortness of breath
2) Pedal Edema ( Water accumulation in the ankle region )
3) Chest Pain
4) Orthopnoea ( More shortness of breath in night time )
5) Low urine output.
If he develops these symptoms, then you can go for angioplasty. However currently there is no such need.
You can get his ECG and ECHO repeated after 3 months to check for ejection fraction. If it is well preserved then again no intervention will be required. If it is below 65 %, your doctor will himself do an angioplasty.
Regarding STATOR-80, it has to be continued lifelong to keep the cholesterol levels down.
Hope this was helpful,

Patient replied :

they did ultra sound test in which they found that he have fatty leaver and galblader stone but doctor said him dat the pain is not for liver or galblader because the pain would have decreased by drotin ds if it would be of liver and galblader they are saying the pain is for istimic change
and currently he is fine externally
sometime he feels pain at right sidde of cheast which decreases after he takes medicine like digene
he feels shortness of breath only during november december january and february not other time of the year
and do he need to take any ther medicine???
dont he require hymoglobin medicine as he is fuffering from anemia

Expert:  Dr. Vivek Mahajan replied 1 Day.

If he is fine currently then no other intervention is required.
Just watch out for the symptoms as i told you.
The chest pain which settles down on Digene is due to reflux, and it is age related. Avoidance of fatty or oily foods will be helpful. Also keep a strict control on his diet, since he also has fatty liver.
The shortness of breath during winter, is due to asthma, and during those episodes, Asthalin will be helpful.
His anemia is not severe, however prophylactically Syrup. Zincofer 2 teaspoons can be given at bed time.
Continue STAMLO-5 and STATOR-80.
Once you get repeat ECG and ECHO, kindly upload your reports in the next consult. Based on that we can decide on further intervention.
Hope this was helpful,

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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