A 65-year-old normal body weight patient of RHD, MS. In 1981 mitral valve dilatation done. In 2006 prosthetic valve placed and CABG done for chest Pain with coronary thrombosis. In 2013 angiography done only. In 2015 PTCA done one stent placed. He is on clopidogrel, aspirin, nitroglycerin, acenocoumarol as required, metoprolol 50, atorvastatin, diuretic. Three monthly check up by his cardiologist.
From 2013, frequent visits to hospital increased in morning hours 6 to 8 am and other times also for giddiness and dizziness and chest pains. ECG did every time shows AF and irregular rhythm defects. 2D -Echo of Heart shows LVEF is 60%, no RWA, mild TR, mild PAH 35+RAP. I stopped his Kapalbhati and neck rotation exercise and added Ivabradine 5 mg bid and patient started feeling energized and Hospital visits reduced. Am I wrong or right? Can it be the only reason for patients cardiac condition?
