65yrmale angiography done 4yr back .since than he is on nitrate antiplatlate station antiht.lipid was normal since early.bp 140/90 controlled on anti ht .stress thallium -ve.how long these drugs to be continued except anti ht
This pt has hypertension, CAD, ASYMPTOMATIC ,CTO RCA , negative inducable ischarmia.he needs life style modification life long ANTIPLATELET statin b blocker for mortality benefit. Nitrate can be stopped if angina then u can restart . By guideline as pt is ASYMPTOMATIC thallium negative , pt don't need angioplasty. OPENING CTO RISK WILL BE HIGH .
Treatment should be life long and if thallium is negative for inducible ischemia then there is no benefit of revascularisation CABG or PCI. just keep on medical management till any new sign or symptoms appear.
Dr vijay Gupta sir ABOVE Patient don't need either angioplasty noR CABG, Whether he is DM OR NOT doesn't matter.
better if he takes for life time,and RCA needs to be stented
In era of evidence based medicine we should follow guideline rather than our person opinion.
Dr anirudha no role of CABG IN SINGLE VESSEL Involing RCA
This pt is completed worked up and require optimal medical management with life style modification only.
the treatment should be life long.in figure there is 100% block so patient need CABG
medicines r must for life time regular checking and monitoring also must may need surgery b prepared
Cases that would interest you
- Login to View the image
case 45 m of chest pain bp 180/100. pr100. spo2. 98. history not clear may b cardiac pt since 2years..... question is ………… pt is from very poor family. is any specific additional trtmnt ………… refused for further investigations………on the following trtmnt…… ivf tirofiban. enoxaparin rosuva tri. rami enzymes neg
Dr. Dinesh1 Like15 Answers - Login to View the image
72 yrs Female, DM , HTN , with abdominal burning with vomiting ECG enclosed please interpret.
Dr. Naveen Arichwal2 Likes15 Answers - Login to View the image
A 45year old male presented with complaints of Dyspnea on exertion and pain in chest left side esp after heavy metals and exertion. T wave inversion are present in V3,V4,5,6,I,avl and ST depression in lead II I have started treatment for CAD and started on lipikind AS at bedtime. please give your valuable inputs about further workup and treatment.
Dr. Ajeet Singh1 Like19 Answers - Login to View the image
A 45 year old male with typical chest pain of 3 hours. ECG attached. Diagnosis?
Dr. Rama Chauhan8 Likes97 Answers - Login to View the image
A 43 year old male came with chest pain of 1 hour. On reaching ED he was asymptomatic. ECG done. Interpret.
Dr. Kadam Reddy0 Like17 Answers