Medication/Prevention

[annie]

I had a heart attack 5 years ago that left no damage.  It was caused by a blood clot.  I am 57, x20 overweight, and my recent readings for Cholestral came back at Chol: 240, LDL 169, HDL: 55 and Tri's were fine.  My ratio level was about 4.5%.  Treating physician was not concerned, but suggested that I see my cardiologist.  I went in for stress test and it looked okay.  Dr was concerned with numbers and said he wanted my LDL's at about 100 and wants to prescribe medication for high cholestral.  I am currently taking no medication as I had alot of problems with digestion and reflux after the heart attack.  Cardiologist who treated heart attack asked me at the time if I ever had problem with hiatal hernia - didn't even know what that was but since attack have had issues with reflux and digestion.  I am currently working with trainer and try to meet once a week and get to gym 2x/week.  Am also working with nutritionist and cutting way back on saturated fat.  Do I need medication or can I control this with exercise and diet?  Would some type of aspirin treatment help also if I can tolerate?

[CCF CARDIO MD - DLB]

If you really did have a heart attack in the past, most cardiologists would recommend aspirin, assuming your stomach can tolerate it, as well as a cholesterol-lowering medication.

[annie]

According to EKG and other tests in the emergency room, I was diagnosed by cardiologist as having a heart attack and that is on my medical record.  Coumadin(sp?) was prescibed as well as other medication at the time.  That was all discontinued by heart specialist after one year.  No medication was recommended.  

I am now seeing another cardiologist and they are recommending lipitor for cholestral levels.  That's all.  Should I be getting a second opinion at this point?

[CCF CARDIO MD - DLB]

Most cardiologists would also recommend that you be on aspirin, unless you had real trouble with your stomach/esophagus. It decreases the chance of another heart attack. Clopidogrel is another medicine like aspirin, but it is a little easier on the stomach (also more expensive).

[Mark G.]

"If you really did have a heart attack in the past, most cardiologists would recommend aspirin, assuming your stomach can tolerate it, as well as a cholesterol-lowering medication."
-
The above is an answer to a previous question to another poster. My question is; is a beta blocker or ace inhibitor absolutely neccessary afer a coronary triple bypass from a persistance angina pectoris attack that left no dead heart tissue? I have trouble tolerating BP medications and my doctor moreless left taking it or not up to me for he feels my 165 is anxiety related.

My BP stays about 165/74 to about 145/70 and pulse 70 to 85.  My total cholesteroal with no medication but via exercise and smoke cessation is 185 with LDL at 70 and my TC-HDL ration at 4.7.

Thus I only take an aspirin now since my surgery on 12-23-98 and have absolutely no angina or any heart problem symptoms.  i do heavily load up on my vitamins and minerals though - folic adid that is in One-a-Day 50 Mupltiple which I hope is enough; 1 to 4 G of C, 400 i.u. of E, 100 mg B-Complex, Ginkgo Biloba at 120 mg, 500 mg of Korean Ginseng, 1.2 G Soy Lecithin, 1 to 6 G of Bee Pollen and 1.8 G of Garlic BUT ...

since starting on my apirin every day I developed severe red radiating and burning eczema at the crease of my elbows and horrible forearm itch that is non - responsive to all hydrocortizone and steroid preps by dermatologist.  I am unsure but ssuspect it may be th aspirin - is it possibe I am allergic to aspirin?

Thank you in advance for answering what you can, for your kindness, and for your valuable time.

mark - Shamokin, PA

[Mark G.]

I apologize for placing this above question in this thread - I meant to post it in a new one. I apologize and will be more careful in the futere.  Please ignore the above post and refer to the repost in the new thread on 11-17-99.

Apologetically,
Mark - Shamokin, PA

[CCF CARDIO MD - DLB]

Aspirin can cause a rash, but rarely. However, you are on so many different medications, it is difficult to say which one is causing the rash. I would suggest stopping all the different supplements and seeing if the rash improves. In addition, your doctor could consider switching you from aspirin to clopidogrel, an agent similar to aspirin in terms of efficacy, though more expensive. Since your blood pressure is elevated at times and since you have coronary artery disease, I would also recommend an ACE inhibitor. I would not categorize the medication as 'absolutely necessary,' but there is good evidence that it improves long term outcomes.

[ginny]

Dear Doctor,
My husband has a clotting disorder and heart problems.  His rhuemotologist recommended Plavix as an anticlotting agent in addition to the 325 mg. enteric coated aspirin a day.  Why did he do this, and is it more beneficial if you have a history of blood clot?
Sincerely,
Ginny

[CCF CARDIO MD - DLB]

The doctor did this because the combination of medications is more powerful than either one alone in preventing clots. Exactly how safe and sound this logical approach is will be determined by several ongoing studies.