Question: Is there a difference in the treatment of hypertension in the elderly? Answer: In clinic today, I saw an 85 year old woman with Parkinson’s disease for follow-up of her high blood pressure. Her pressures have been difficult to control. Today her BP is 170/80 with a heart rate of 62 bpm. She is taking an ACEi and a …
I had an echocardiogram that showed pulmonary hypertension. What does it mean?
Question: I just learned that an echocardiogram from 2.5 years ago indicated “mild pulmonary hypertension.” (sPAP was extimated at 38 mmHg.) The echo was done to try to diagnose sudden attacks of shortness of breath that have become less frequent since then. (No luck with a diagnosis, by the way.) My brand new pulmonologist wants to do another echo and …
Blood pressure problems after PCI
Question: My husband, age 40, has a past history of double bypass and 13 stents (terrible family history). He had another stent placed this past week at the proximal end of his RCA. This is a ‘HUGE’ artery according to his physicians. He was recently placed on the new drug Effient instead of his usual Plavix. He was discharged home …
Percutaneous Coronary Intervention (PCI) – Risks & Benefits
A 58-year-old man has chest pain at 9:30 a.m.; 3 hours later, he calls for an ambulance. Paramedics arrive, provide standard treatment, and transport him to the nearest emergency department. On his arrival at a small hospital at 1 p.m., the findings are diagnostic of a myocardial infarction with ST-segment elevation. The emergency department physician recommends immediate transfer to a …
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