EECP vs Better Non-Surgical Options: 61F Post-Pulmonary Edema (TVD, 42% EF)
61F. Frail/thin. Hospitalized last week for 1st time with acute pulmonary edema (now resolved). Currently stable: lungs clear, SpO2 98%, Pulse 82-85, FBS 155, PPBS 198. Has intense thirst and fragmented sleep.
Angiogram: Severe TVD. LMCA 30-40% stenosis; LAD total occlusion (filling via active collaterals); Distal LCX 90-95% stenosis; RCA total occlusion (retrograde filling). Surgeons advised against CABG/PCI due to frailty; recommended medical management as collaterals are compensating.
2D Echo: EF 42%, mild PAH, multiple hypokinetic LV segments. Chambers/IVC normal.
Meds: Axcer 90mg BID, Aspirin AV 75/40, Bisoprolol 1.25mg, Angispan 2.6mg, Oxra 10mg, Tab Leni 40mg (1.5 tabs/day). NovoRapid (10-10-8) + Lantus (10u at 10 PM). Strict 1L fluid limit, zero-salt diet.
Questions:
Can EECP safely mature her collaterals, or does increased venous return risk re-inducing pulmonary edema so soon?
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Dear Sir,
Suffering from mid spine bearable pain, but tingling in hands and legs and face jaw, some time feel like I'll faint but not yet fainted, imbalance feeling but I can walk and drive bike normal, my body weight 108kg height 5ft 7 inch, no sugar, blood report and ecg normal, 2decho normal, ...iam just worried of tingling in hands upper skin, and imbalance feeling it's irritating. Please help with your suggestions why this happens and root cause.
