Hello sir,
As per the previous video of Dr Rahul sir, ct angiography should not be suggested to low bmi, post plasty, calcified plaque patients. (Reports are hampered due to high calcium score)
If above category patient came first time with catheter angiography reports with expectation of mainly plaque reduction; how to check his plaques before and after ? And what to promise if that block can not measured?
Secondly if calcium is deposited in vessels, is it causes problem ? If yes How to reduce that calcium? ( as per my knowledge we are working mainly on volume)
Ambulkar sir had said once to use laksha g tablet in cad med video..
One of ayurved practioner said it is asthi vimargagaman in ras.. so use medicine like erand paak, ras pachak , asthi majja pachak
Please guide
Dear Dr Ameya,
Nice sequence of questions, I would like to answer them one by one.
If a Post CABg/Calcium score above 1000/Unstable angina patients is coming to us with an expectation of reduction in blockages. We can ask them to go for non invasive options like GLS and SPECT Scan, invasive options like FFR and IVUS as per patients convenience, medical conditions(normal renal and Liver) we can ask them to go for direct or surrogate blockages assessment parameters.
In coronary artery disease, calcification is outcome of chronic inflammation, mineralization in coronary is part of plaque stabilization to prevent acute coronary event. absence of inflammation for longer time with Daily Exercise can replace calcified tissue with normal connective tissues and collagen fibers.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366344/
So we have to target exercise capacity(Pk HFRT and IRP are having proven efficacy in the improvement of VO2peak) of our patients, if we can improve and sustain the improved quality of life that will help him to reduce calcified plaque.
In current observation, Use of Madhavprash in 10gm TDS dose,Jwarmed(Raspaachan) intermittent fasting, Sasneha Virechana has helped us to reduce calcified coronary plaque.
So along with panchkarma therapy, regular exercise and above mentioned medication can be helpful to correct anatomy and morphology of coronary arteries.
Please Note: In my video I have mentioned that We can include post PTCA cases.
Thanks sir for your valuable guidance… one more question… can you explain in brief about spect scan, ivus and ffr( in cad podcast rohit sir has mentioned abt ffr )
How to write the referral note ?and approxinate cost?