Peripheral vascular disease & elevated creatnine levels

63 years old woman with a history of peripheral vascular disease. Vitals: Temp 99.4 P-110/min RR 28 BP 140/80 O2 sat 92% on 2 L PE: SOB, bilateral crackles, tachycardia, no JVD or lower extremity edema Labs: Na+ 138, K+ 4.7, BUN 35, Cr 1.2 CXR: cardiomegaly, mild vascular congestion EKG: Sinus tach, old lateral ischemia Her creatinine was markedly elevated at 3.9. Can we do anything in such case/ She is kapha pitta prakriti and has vishma agni bala

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Pomegranate juice raw juice, drumstick soup carrots tomatoes no tomatoes in cooking, muskmelon
GANGRENE- Peripheral Vascular Disease (KOTH) rakta mokshan with leech manjishta kwath se wound dhawan serum creatinine levels raised Virechan and vaman will help. alos gokshuradi guggul withchandraprabha .Dhanyakadi kadha
Start Plant based raw diet rich in vit c & Antioxidant mainly. Proper rest n sleep Manage stress Manage Constipation. Correct electrolyte n renal function on priority basis to avoid any further deterioration.
Rx Syp Cardoriumplus 30ml OD Tab Prabhakar vati 2BD Tab Punarnavadi Guggulu 1BD
Pushkar guggulu 4 tab BD will give relief for sure. Also, nitya rechan should be planned.
Find out subjective symptoms and prescribe medicine according to totality of symptoms.
Arsenic alb 200/3dose Latroductus30/tds Advise -restriction of oily things
Gangrene Virechan and Rakthmoskshan Prakshalan with manjistha kadha
Give medicine based on ur presenting totality
Cardiologists Opinion Needed.
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