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Dr Vivek

Dr Vivek Mahajan  |40 Answers  |Ask -

Cardiologist - Answered on Apr 13, 2023

Dr Vivek Mahajan is an interventional cardiologist with over 10 years of experience.
He specialises in treating heart ailments and cardiac interventional surgeries.
He has been working as interventional cardiologist and electrophysiologist at Fortis Hospital since 2013.
Dr Mahajan has a postgraduate degree in interventional cardiology from the Post Graduate Institute of Medical Education and Research, Chandigarh, and a master’s degree in medicine from the All India Institute Of Medical Science, New Delhi.... more
S Question by S on Mar 30, 2023Hindi

Dear Doctoe,I suffered an MI 12 days back.ECG Showed acute MI-I am a diabetic and hypertensive patient.I am male-61 years.On being admitted Drs did an ECH and Angiogram which showed no blocks.I was discharded on dsay 3 wirth medicines to be taken and after a week to meet Dr.Day before yesterday i met Dr,in OPD.he said yes it was an MI because of poor flow of blood to heart and reason is my habit of smoking. Now i feel better with occassional Short off breath and lil pain in chest at times.I am having Ecosprin gold at night,nikoran 5 in morning and night,cordadrone 200 in morning and contin uing glimisave m2-bd and zomelitis 50-500 after noon.Am i on right track-Any precautions other than no smoke npo drin k wakking 30 mts daily,health food,no oily stuff and red meat.please advise

Ans: A 2d echo needs to be done to evaluate your heart function. if the heart is weak then heart failure medicines need to be initiated. there are better blood thinners that ecosprin Gold in the heart attack setting like aspirin + ticagrelor. There are better anti diabetic medications like SGLT2i for patients with heart attacks which should be initiated for you. There needs to be a risk factor evaluation as to why you got a heart attack apart from smoking
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.

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Consultant Physician, Internal Medicine and Critical Care Expert - Answered on May 30, 2023

Asked by Anonymous - May 27, 2023Hindi
Hello Doctor, I am 44. I was suffering from gastric issues Somewhere in Oct 2021, i started feeling anxious and all negative thoughts. As a nature, i take good care of self. But due to this anxiouness, i was unable to sleep well or even concentrate well. I thought to consult a MD and he took my BP reading, which was in range of 142/90. He avoided started any medications and advised for lifestyle changes to alter this situation, to which i stared with certain life-style changes like, - sun-bath in morning. - walking - morning & evening - meditation - in evening. i continued this till Dec 2021 and again revisited the MD in Jan 2022, to which he advised to continued with the same routine. By March 2022, i was feeling better. Again, the same story repeated in Sep2022 and this time, with lot of gastric issues, sleep troubel and feeling of fear and anxiety and again i visited him in Nov 2022, was getting more anxious. Looking at my condition he started with beta-blocker. The condition was not very much improving and i took the blood tests on my own in Nov 2022 end, to which, Lipid profile was bit out of range, HaB1c - in pre-diabetic zone and in liver tests - SGPT was 62. I visited to the MD with report and he advised me to continue with beta- blocker and to start with the statins daily 10 mg, after dinner. I continued this for Dec 2022 with life style change with yoga and meditation routines along with walks. In Jan 2023, the tests were repeated and it was all NORMAL. The doctor advised to stop the medicines wef Jan 2023 and again advised to repeated tests in Feb 2023. In Feb 2023, all parametere were normal , but Lipid profile was again out of range. The MD again started with the same medicines from March 2023 onwards ie 1 beta - blocker in morning after break-fast and 10 mg statin after dinner. I repeated the tests in April 2023 and it was again all NORMAL. Now, the MD reduced the statin drug to 5 mg from 10 mg and continued with beta - blocker. I am leading a healthy life with yoga, meditation, diets with more fibres and less oily or say no oil deits to the extent possible. I have stopped eating any outside food and fully on home made food only now. benefits till now, - Sleep paterrn improved - Gastric issues has gone - IBS gone, - better mood My questions to you sir, - The MD is again planning to stop the medications in next visit, since all reports are normal and i feel normal. is that okay? - Again, i may develop the symptoms? - I am following a better life style - yoga, meditation, walkings, proper diets, are there chances that i would remain off medicine always? - What are the benefits and disadvantages of station and beta -blockers, if at all, i have to take it? thanks.
Ans: Beta blockers have probably been prescribed for your symptoms of anxiety but they can increase the levels of the lipids. You need to consult a psychiatrist about the best treatment for anxiety.
Ideally statins need to be taken for long because the lipid levels are bound to go up once you stop the statin. We need to decide however whether you really need a statin at your age. Do you have a family history of premature heart disease. If you do not have a family history of premature heart disease, you can probably stop statins for a few years . Can consider doing a CT Coronary calcium score

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General Physician - Answered on Jun 07, 2023

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Hello Doctor, I am 44. I prefer healthy life and all nice in terms of health, except that I was suffering from gastric issues, IBS and related issues. I had covid also in April 2021 and somewhere in Oct 2021, i started feeling anxious and all negative thoughts. In about Aug 2021, i noticed that my heartbeats is high than normal, which initially i tried to control with routine meditation. But somehow, was not feeling that well from within and mind was like getting anxious, as if , something is happening which i could not understand, what. I visited to MD - Medicine, in Oct 2021. As a process, the vitals were taken and BP reading was taken which was 145/90. The concern MD, which after going through the reading, did not tagged me as BP patient and advised me to have changes in lifestyle with yoga, walking, meditation and dietary changes. I throughly followed the advised and started feeling better from Jan 2022 onwards and it was all nice. Again from Sep 2022 onwards, i started feeling the same issues. And i visited the MD in Oct 2022. From Nov 2022, he put me on 25mg dose of beta-blocker , daily in the morning after breakfast. While, i was on beta-blocker, i was still not feeling that nice from within and i unilaterly took the decision to go for complete blood tests in Nov 2022 end. The results were, - Lipid profile - was disturbed. - Sugar : I was in pre-diabetic range. - Uric Acid : I was on borderline high. I visited the MD with the report and he add another dose of 10 mg of Statins from Dec 2022 onwards. I followed the medication along with dietary changes, yoga & meditation routine and took the tests in Jan 2023, which shows the results as under, - Lipid : Normal - Sugar: I was back to Non-Diabtic range from pre-diabetic. - uric acid - normal. And all other parameters improved too like Hemoglobin - 15 and all other paramters of cbc was normal, thyroid - normal , Liver function - normal - when certain times SGPT was bit on higher sides, but normal in this report. With this report the MD stopped the statin drug from Feb 2022 onwards and advised me to continue with beta-blocker of 12.50 mg instead of 25 mg. I followed the same routine for full Feb 2022 and again took the test in March 2023, and results were as under, - Sugar : non-diabetic - all other paramters - normal - Lipid - Not normal. So again from March 2023, the MD started with the same statin dose of 10 mg and beta- blocker of 25 mg. I took the test in April 2023 and again the reports were normal, so now, again he reduce the statin dose to half ie 5 mg and continued with the same dose of beta-blocker 25mg. My questions: 1. AT present, i follow proper diet schedule as prescribed by dietcian , have been doing meditation and yoga on regular basis. 2. Stress level is minimum. 3. I am feeling overall better. 4. BP levels are always normal 5. Gastric issues, IBS seems to have gone. 6. Sleep patern is improved. My question: a. I feel, in the next visit the MD may stop the statin. Can the lipid profile remain in normal range , when i am follwing all diet patterms , with yoga and exercise. Why the lipid profile became abnormal, previously even when i was following all routine very property ? b. Is it okay to consume beta - blocker 25mg regularly, even after doctor told me to stop statin or may stop my statin in next visit? c. Is there any way to know, to find, if i am feeling better normally or due to medicine? as i am feeling normal and unable to check, what after i stopped beta-blocker? Any other care which i should take and lead a healthy life.
Ans: Hello. These are good questions and a lot of people go through the same stages. Cholesterol levels are generally genetically determined and don't change much from dietary or lifestyle changes. It can be reduced by medications. However if it is the only risk factor for heart disease/stroke, then it need not be corrected unless it is very high, LDL> 160. On the other hand the B blocker, if it was taken only for BP, may be stopped if BP comes down and remains normal. A closer monitoring may be required for that. If BP stays normal or low on taking the medicine, reduce the medicine and recheck, if it still stays low or normal, stop and see. Take it slow.

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Latest Questions

Ravi Mittal  |254 Answers  |Ask -

Dating, Relationships Expert - Answered on Jul 23, 2024

Asked by Anonymous - Jul 21, 2024Hindi
Me and my boyfriend are in long distance relationship from past 6 months, I told him about my past in almost starting of it that I had 2 friends with benefits in past and one of that person was my classmate as well as friend, and he used to still contact me, and when I came in relationship also, he called me during that time and I told regarding my relationship status, and I also informed my boyfriend that I talked with him but this thing happened before he knows that I had physical intimacy with him, then when he asked me to block, I suddenly question "what is the point of blocking him" which I regret the most, but I blocked him later by myself, now my boyfriend is sayine me that I have cheated him and he won't trust me till his death, but I told everything in past happened to him. I love him a lot but he is not giving to work together in this relationship and saying that he won't stay loyal to me anymore, he won't trust be ever, as per him I have cheated him, but my intentions were not wrong at all, tho that guy was in contact but I never initiate any conversation with him while I came into relationship, is it really a cheat, is it that he should not trust me anymore? Please guide
Ans: Dear Anonymous,

It sounds like you are going through a rough time and I am sorry for it. Here's a thought and I am sure you have thought of it too, try to see things from his perspective. While you know that you never cheated nor meant to, it is important to acknowledge that your boyfriend's feelings are valid. He is feeling betrayed and that's a fact. Now, our goal should be to fix this issue. How do we do it? Communication is the only way. Tell him that you understand his perspective but it is important that he sees yours too. If he wants to vent, listen to him. Do not interrupt or become defensive. Understand whatever he says is coming from his insecurity. I know it's difficult not to take it personally, but his statements will be a reflection of his feelings and not your character. Remember this during the conversation. Once he is done speaking, reassure him that you had no intention of cheating. You can also reassure him of your commitment. Promise to be more transparent and point out that you were honest with him from the beginning. If you had any intention to cheat, you could have easily not shared with him your past. But you did and that shows that you are committed to this relationship. Tell him that you understand the need for boundaries and it is not okay to be in touch with people who make your partner uncomfortable.

Look, rebuilding trust needs work and it also takes time. Both of you need to work on it. You will have to work on making him trust you and he will have to work on letting go of his misconception (which might be his reality) and trust you wholly again. Relationships don't work till two people trust each other completely. If he continues to say that he can't trust you again, it might be best to reconsider this relationship. Even though your words hurt him, you did not cheat on him in reality. Why should you have to live in fear that he will cheat on you merely to take revenge?

After you put in all the effort, see where it goes. If things do not get better, rethinking the relationship would be best. Everyone deserves someone who can trust and be trusted.

Best Wishes.

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