Heart & Cardiology/CAD Diagnosis


ecg stress
ecg stress  
QUESTION: Dear Respected Sir
I am a Year 2 MBBS student and my dad is aged 59years.He is hypertensive and was doing well with 5Mg Amlodipine.(Norvasc).He is 96kgs/Height 174Cms.
From the last 10 days he has been having chest pain which was more if he walked fast,it improved slightly with omeprazole.He has been on Etoricoxib 60mg from about 4 months due to arthritis.Before this he was taking Diclofenac Sodium from a eriod of 2 years.He is also taking Gabapentin 400 mg due to slip disc in c6.

My dad did not want to visit a cardiologist as he claimis he dad similiar pain 30years ago.

I forced him to see my professor in the hospital,A MRCP Cardiologist.The ECG was normal,he advised to come visit for a stress ECG.On doing the stress test,He started feeling pain at 4.5mins due to which test was stopped.
The doctor advised to do an angiography and labelled the result as strong postive.

He prescribed the following medicines:
Clopidrogel 75mg,Bisoprolol fumerate 2.5mg,Aspirin 100mg,Atrovastatin 40mg.Amplodipine to be continiued.

My dad has been in a state of denial and angry with me,he refiused to do the angiography and refused to take the medications,he calims that he is well and that I am trying to label him as diseased.He is being angry and sad.

I have convinced him to take the other medication expect the beta blocker bisoprolol,he is takiing the Amplodipine 5mg.

My question is whether the stress ECG can be false positive?Is there any other way to diagnose CAD non invasively.
Is it Ok if he skips the Betablocker,His BP is controlled.It increased only while doing the strees till around 198 systolic.

His right eye has been red from yesterday.Is this dangerous.(we did the stress ecg day before).

I would like your expert advisein dealing wit this as I am extremely worried.

Kindly reply at the earliest

Thank You for your time..

ANSWER: Hi Mamoon,
Please read my answer here:
Hope this helps,
Dr T

---------- FOLLOW-UP ----------

He does not want anything invasive,Please advise if excercising is good fr him as he was physically inactive.
Can the stress etst be false positive.
Is it alright if he just takes these medications,are they alright?
he has refused to take the beta blocker,is just amplodipine enough?

thank you so much for your time

Hi Mamoon,
Your father is his own boss. If he doesn't want to be treated, that is his prerogative. If his meds take away, and he starts living a heart healthy life style, it might help (although I doubt it):
With symptomatic coronary artery disease, it is VERY unwise to start playing around with what medications he wants to take (it is quite another thing if there are side-effects).
Hope this helps,
Dr T

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