Doctor insights on:
Why Exactly Are Ace Inhibitors Contraindicated In Renal Artery Stenosis
It depends: On the clinical situation. Ace inhibitors are commonly used to control BP in renal artery stenosis and are not contraindicated. Their is this concern that ACE inhibitors may worsen ischemia to the stenotic kidney and for this reason patients have to be closely monitored. ...Read moreSee 1 more doctor answer
Arteries are defined as blood vessels which carry blood away from the heart (to either the body or lungs). Arteries: higher pressure, thicker walls, stretch (pulse) with each heart contraction & deliver blood to the arterioles which control the flow to individual capillaries. Veins are blood vessels which carry blood from capillaries back to the heart (body to right heart; ...Read more
How are loop duretics used for acute renal failure and CHF though ther are contraindicaticated in borderline RF and CHF ?
Medicine vs. poison: There's a saying in healthcare: "medicines & poisons r the same chemicals given with different intent". If u r volume overloaded in acute renal failure or CHF, then u need volume reduction. The easiest & fastest way is diuretics, which "force" the kidney to get rid of water, tho side effects can occur (so u have to b monitored). If there is no volume overload in renal failure, skip the side effect ...Read more
Clofibrate: Clofibrate is a lipd lowering drug that is metabollized in the liver. Those metabolites are excreted in the kidney. When renal failure/insufficiency happens, the drug itself as well as its metabolites build up in the blood. High concentrations of these metabolites can lead to serious side effects including death. So, don't take Clofibrate if you have renal disease. ...Read more
Why are ACE inhibitors particularly prescribed for persons with left ventricular contractile dysfunction?
Does treatment with arb's specifically olmesartan 20mg reduces proteinurea to below 30mg even if secondary hypertension is still there in arteries?
Yes: ARBs and ACEi class of drugs reduce proteinuria regardless of the cause of the hypertension (they restructure the anatomy in the glomeruli which are the building blocks of your kidneys) and make the filter in your kidneys tighter (so to speak) to prevent leakage of protein in the urine. ...Read moreSee 2 more doctor answers
Is ACEI or ARBS harmful for kidneys in case on renal impairment (s.creatinine1.7,b,urea39,age72) what are the safe anti hypertensive that can be use?
Can thiazides diuretic cause impaired renal function if it used to control BP inCKD what is the safest antihypertensive drugto be used with CCB&BBlock?
See below: Renal artery stenosis is narrowing of the kidney arteries most commonly due to cholesterol plaques accumulating inside the walls of the blood vessel.There are other causes as well. A cathetor can be inserted into the blood vessel and a balloon can be inflated to restore the lumen size. A stent is inserted to keep it open.There are surgical options in special circumstances, . ...Read moreSee 1 more doctor answer
RAS: RAS due to atherosclerosis (ASO) more often than fibromuscular disease (FMD) Medical treatment does not alter RAS but can control BP. RAS can progress to occlusion. Controlling ASO risk factors appropriate. Open renal bypass infrequent. Angioplasty/stent more common but controversial. PTA probably Rx of choice for FMD. PTA/stent for ASO if flash pulmonary edema, uncontrolled BP, renal failure. ...Read moreSee 2 more doctor answers
Can ACE inhibitors or ARBs given to control Bp if s.cr is1.56 in patient with atrial fibrillation?
ACE-ARB, CRF A-FI: ACE and ARB in chronic renal failure can be administered together. However will have no therapeutic effect on chronic atrial fibrillation. For arterial hypertension with chronic renal failure you will require to switch one of the current HPT med to a beta blocker. Such as Sotalol 80 mg twice a day (minimal dose), and have BP controlled twice a day, adjust as . Have you ever underwent cardio-versi ...Read more
The company it keeps: There are no "markers" for microvascular angina, per se. The diagnosis can be made invasively at specialized centers (only a few around the country), but often is based on a "gestalt" of suggestive symptoms, sometimes with evidence of impaired blood flow ("ischemia") on stress tests, in a person with traditional heart disease risk factor, when typical angiograms show no blockages. ...Read moreSee 1 more doctor answer
Does chlorthalidone cause impaired renal function in CKD, what antihypertensive is safe to HTN (now using lercanidipine 20,metoprolol 25mg), in73yrpat?
CTD IN RENAL FAILURE: 28 F Iraq asks if CTD can cause impaired renal function in CKD AND what is safe BP med is safe in 73 yr pt? ANS: depends on stage of CKD and cause. It can be very good to help lower BP. But if BP gets 2 Lo may worsen. I specialize in this and happy to do 2nd opinion consult with U. HI BP in CKD often driven by eating more salt than kidney can get rid of. Estimate Na intake using fitness pal. ...Read more
About Acute Coronary Syndrome, why do you think Carvedilol (betablocker) is given with aspirin.. it was contraindicated with each other right?
Is coronary artery disease the same as arteriosclerosis and myocardial infarction? More specifically how are they related?
HEART ATTACK: Coronary artery disease is disease of the arteries to your heart. Atherosclerosis is hardening of those arteries. Myocardial infarction is injury to your heart muscle because oxygen carrying blood could not get thru your diseased , hardened coronary arteries. = heart attack. ...Read moreSee 1 more doctor answer
What level of Obesity or BMI level do you usually see patients with known heart artery stenosis blockages ?
Possible: Troponin elevation is indicative of myocardial tissue injury (in absence of other noncardiac causes e.g. kidney disease) which may result from valvular disease through decreased blood supply to the heart. BNP elevation ususlly indicates increased cardiac stress such as in heart failure (that can be from valvular disease). Significance of elevation of either should be correlated clinically. ...Read more
Post operatively: People are reluctant to give pre op patients with critical aortic stenosis inotropes. They stimulate the heart, but in the case of dobutamine and milrinone (most common phosphodiesterase inhibitor) they also drop the aortic pressure past the valve, and that can be very bad. Post op, PDE's can be preferable to other inotropes because sympathomimetics worsen the stiffness of the thick LV. ...Read more
Beta blocker ( 5 mg bystolic) is causing lot of bad side effect. Would arb/hct or ACE be good replacement to treat coronary artery blockage.? Thanks.
Stenosis is narrowing so renal artery stenosis is narrowing of an artery that sends blood to you kidney. The effect usually is your blood pressure goes up and in my experience this is the most difficult kind of high blood pressure to manage using medicines. It usually requires some kind of repair ...Read more
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