75yr old female known CAD-TVD (CAG Done in 1999 advised CABG but refused by pt.)presented with c/o Shortness of breath (NYHA III), epigastric pain since 1yr.2D Echo revels Sev MR,EF-30%.Presently she is on Rx: Ntg(2.6) Clopivas AP Statins Now what should be add on treatment.


case of Ischaemic Dilated CARDIOMYOPATHY Pls mention her Bp and HR... Single Antiplatelet is adviced considering her age Moderate intensity statin like Rosuvas 20 mg or Atorvas 40 mg if she can tolerate with normal Liver functions irrespective of and Lipids Low dose cardio selective beta blocker keeping HR target less than 76/min if Bp is permissible and No heart blocks on ECG Low dose Acei/Arbs considering bp and S.creatinine T.Lasilactone (20+50) in bed (Lasix+spironolactone)...So, check for electrolytes and create Biweekly... Daily weight record to titrate the doses of diuretics Low salt intake less than 5mg nacl/day Restricted fluid intake up to 1 litre /day Blood sugars control Check T.Tsh Laxatives
Hb% levels monthly...
Hello, it is a classical case of ischemic dilated cardiomyopathy. kindly start digoxin 0.25 mg 5 days a week, ACE inhibitor and dieuretic based on her volume status and blood pressure. once she is optimised on these you can start beta blocker. kindly hold beta blocker until then as it may worsen SOB. advise fluid restriction and salt restriction appropriately. if the ECG shows LBBB pattern and SOB is refractory she will be eligible for CRT. continue antiplatelets ( only aspirin) and statin.
1)A CASE of SEVERE---MS with LVEF--30% --CAG.done 2)X-RAY---- CARFIOMAGELY WITH CCF-PT. IS IN EARLY FAILURE 3)REPEAT. CAG ---IF LESS THAN---3-Blocks THEN cag /c abg 4)if PT. IS not willing for cabg THAN DO ptca 5)after ptca pl.try to correct SEVERE MR 6)IF PT.IS NOT WILLIND FOR ANY SURGICAL TREATMENT THEN a)medical line of TREATMENT ----oral coronary dilate -----oral LASIX ----
Heart Failure... Check BNP levels.
diuretic if BP permits
She'll need diuretics.
Best beta blocker would be carvedilol 3.125 mg BD. add Digoxin 0.25 1/2 to 1 od diuretics torsemide. eplerinone 25 mg od.dobutamine infusion 2ml/hr. add ivabradine heart rare is not controlled. prophylactic cardarone if multiple ventricular ectopics.
She has cardiomeagaly. Looks like dilated ischemic cardiomyopathy with severe Lv dysfunction EF Very low. Diuretics. Low dose betablockers trimetazidine.pl.think of sacumabitrol& valsartan combination for cardiac failure
we have to maximise the medications for heart failure and diet if it's refractory then ventricular assist devices as a bridge to heart transplant as a last resort
ischaemic dilated cardiomyopathy. add beta blocker carvidolol, ace inhibitors, spiromide, l-carnitine, low salt diet, water intake upto 1 to 2 litre per day
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