Extreme weakness/Difficulty standing

A 55 year old male presented to OPD with complaints of weakness and unable to stand and do his work like before for almost an year now History He is a known case of Angioplasty with one stenting done and was on Metoprolol XL 25 OD, lasilactone 20/50 BD, Telista 20, and Roseday F 10 Investigations His S. Electrolytes are completely normal Management How to deal with this case? What could be the probable reason for his weakness?

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Is his BP controlled, does he need diuretic for control of BP ?Better to substitute diuretic with other drug/drugs.prolonged use of diuretic usually give rise to electrolytes disturbances even if one report is normal. Another reason could be cardiac neurosis for undue weakness. Another reason may be further progression of CAD for which investigated renew.

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As patient have sypmtoms since almost 1 year With history of PTCA and HTN,on Diuretics beta blockers,statin and ARB Does he really need of diuretic Get done his cardiac evaluation with 2decho Routine lab with BSL fasting PP Check his vitamin B, D3,serum calcium magnesium level Meanwhile treat with IV methycoblamine and antioxidant multivitamin Encourage fluid intake

All the drugs which patient is taking have these side effects Add Vit D3 Vit B12 Iron Antioxidants

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MRI Brain for diagnosis, Ischemia change Cortex atrophy Degeneration of tissues CSF change formation to do age related with mineral resources in incomplete conditions. Poor nutrition vitamins, minerals, Other due to long term use of beta blocker induced, Food absorption Poor sleep Mood change Low blood pressure.

NEED'S .. CLINICOPATHOLOGICAL EVALUATION WITH .. HEMOGRAM .. URINE ROUTINE .. BSR..HBA1C.. HORMONAL STUDY .. VITAMIN B12 .. VITAMIN D .. ECG STUDY .. MEANWHILE TREAT WITH.. MULTIVITAMINS ANTIOXIDANTS .. SYMPTOMATIC T/T..WITH CLINICAL CORRELATION..

Please check all the parameters CBC ESR Urine RM Culture LFT KFT Lipid profile Cardiac marker ECG and echo Vitamin D 3 test Vitamin B12 test All the required assessment and rescheduling Psychotherapy and councelling Diuretic should be discouraged

? may be hypotension ? side effects of duiretics and betablocker please measure bp. tab B12, folic acid, alphalipoic acid, vitamin d3 and pyridoxine

Sproutskalijeeri... almonds without skin... dates.. carrots pomegranates muskmelon walnuts blue berries sunshine ginger walk cherries berries apricots yellow banana...gud til jeera...nuts.... alkaline diet no sugar no nonveg diet no eggs no mushrooms no fried foods no processed or fermented foods and beverages no vyasan... little garlic ... hydration.. coconut water .. limited... chappaties...under strict supervision of Doctor

Get CBC Vit D3 and Vit B12 level.

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Vit B12 D3 must add With clinical diet

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