Hello I posted the other day about my positive report after seeing the Cardiologist in the Out Patients Clinic. So saw the Cardiologist Tuesday 9th July
Saturday 13th July received the Report from the Cardiologist, copied to my GP and Heart Failure Nurse.
I saw this patient in my Clinic today He has a severe ischaemic cardiomyopathy and has previously had a CABG. We know from his coronary anatomy that the LIMA graft to the diagonal branch of the LAD is patent He had stents to the mid-LAD in March 2018. His RCA is non viable and he does have a CTO of his Circumflex coronary artery. Today he tells me since the PCI to his LAD he has had no further Angina, but his Breathlessness still continues to be an issue. His recent Holter revealed a High Burden of VEs approximately 9% of total beats.
Recent cardiac stress MRI confirms dilated LV with moderate LV Impairment and an EF of 43% His RCA was non-viable, as before and Importantly, there was no evidence of reversible ischaemia. Blood Pressure systolic varied between 90 - 120 There are times he has symptomatic hypotension .
It is clear from the MRI that he is fully revascularized from the coronary point of view and does not need further revascularisation. From the Holter he has nocturnal pauses of up to 3 seconds there is no indication for pacing at this stage.
I would like to optimise his Heart Failure medication further and I am keen to double the dose of Entresto to 49mg/51mg. Heart Failure Nurse to optimise, if his blood pressure has increased, after stopping Furosemide and Isosorbide
With regard to follow up I will see him in my clinic in a years time with a repeat echocardiogram.
signed Consultant Interventional Cardiologist
cc Heart Failure Specialist Nurse GP Echo Booking Team - Echo in one year prior to OPA please.
It has run like clock work thank you NHS
Cardiology appointment 
waiting cardiology appointment 
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