s*******n
发帖数: 239 | 1 老爸严重的冠心病，3个月前刚做了心脏搭桥手术。现在术后恢复还好。
有两个问题：
1. 术前就有高血压，以前一直用 硝苯地平 NIFEDIPINE 控制，血压控制的不错。
但是现在医生让改吃 Lisinopril 后血压控制不住，高压经常高到160。是应该找医生
换高血压的药嘛？
2. 前两天散步时可能走得快了点，又一次感到胸痛，几分钟后就好了，这次没有放射
性的痛，这点是和手术前心绞痛的感觉不同的地方。而且最近有时感到胸闷气短。 这
会是什么原因？难不成手术没做彻底？
我们打算去看看医生，约到两周后了，先来这里问问看？哪位大侠能帮着解释一下？不
胜感谢！ |
y*****g
发帖数: 193 | 2 Nifedipine is calcium channel blocker, not good for congestive heart failure
(CHF) patient. That's why his doctor changed his antihypertensive agent from
nifedipine to lisinopril. Lisinopril is ACE inhibitor agentgood for CHF
patients. If his systolic blood pressure unable to control<140, he need go
to his cardiologist to readjust his BP meds. There is a lot of choice or
combination therapy for CHF patients.
If dyspnea on exertion reappeares, he need go to his cardiologist again too.
They need check his 2D echo, compared with the previous study. He might
need stress test/or cath lab again. You never know whether his graft
reoccluded or his another coronary artery narrowed.
Same time, he need on statin drugs, aspirin and health diet/exercise... |
s*******n
发帖数: 239 | 3 谢谢大侠的回复！
Lisinopril 5mg 现在我父亲是每天吃2次，一共也才10mg，是不是可以加大剂量？在看
到医生前，我们可以自行加大剂量么？
我父亲的搭桥手术应该是做了4个graft。因为他的三个冠状动脉均有不同程度的堵塞。
这样是不是就是说如果有再堵塞，应该是在graft上？3个月前刚做的手术，难道这么快
就可能再堵上？这也太可怕了。老爸都70左右的老人了，如果真是再堵上了，是不是没
办法再做大手术了，太折腾了。。。 |
y*****g
发帖数: 193 | 4 If his symptoms or his condition not worse enough to require another surgery
, he didn't need have one. As you said,he has a bad heart already. So
moderate exercise, not too much which will increase his heart workload.
Control his heart rate, so his heart has more perfusion time. Is he on any
beta blocker?like metoprolol or carvedilol? digixon?
Pain in the chest might just one episode of myocardial angina, it doesn't
mean his graft occluded again. What he need is to know how to manage his
symptoms and optimize his medication to make his heart work a little easier.
I can't give your suggestions to increase lisinopril or not. His PCP or
cardiologist who knew him will make this decision. |
s*******n
发帖数: 239 | 5 Yes, he is on metoprolol as well. And Simvastatin at the same time.
他肯定经不起再来一次大手术了，太遭罪了。我们尽量保守控制吧。本来以为搭桥手术
可以把他的冠心病根除了，或者至少可以管个十年八年的，看来我们还是得时刻注意。
再次感谢！ |
