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CALCIFIED PLAQUES IN ICA. Chances of STROKE/HEART ATTACK.

Resolved Question:

MY BP IS 105/80/83 at 9.45 am (after breakfast) . I AM TAKING STAMLO 2.5mg daily after breakfast.
blood sugar is 78mg/dl (fasting) . i got through BRAIN MRI, heart ecocardiogram, lipid profile , blood test etc. BRAIN MRI - Circumscribed rounded focus of T2 weighted, T2 TIRM and T2 Haemo non restricting Hyperintensity across the Left sided Corona Radiata - Ischemic.

DOPPLER TEST(U/S) - mild atheroscelrotic changes in both CCA and ICA. Small calcified plaque(measuring 0.18 x 0.10cms) in left ICAcausing about 5-10 percent stenosis. Normal Antegrade flow in both vertebral arteries. Both ICA are tortuous. There are no evidence of stenotic plaques on the right side.

LIPID PROFILE - Total cholestrol 211.3 mg/dl, HDL - 43.5mg/dl, LDL - 156.1 mg/dl. Very Low Density Lipoproteins 11.7 mg/dl. Ratio 4.85:1.

2D ECO CORDIOGRAPHY - NORMAL.

BLOOD COUNT - Hg - 14.5 gm % , ESR 25 (1 hr), RBC count 4.44,
SERUM BILIRUBIN DIRECT 0.15 mg/dl, ALBUMIN 4.8 gm/dl.
BLOOD UREA - 13.8 mg/dl.
TROPONIN TEST NEGATIVE.
TSH - 12.06 (thyroid test).
U/S SCAN OF ABDOMEN/PELVIS - LIVER - NORMAL - MILD PARENCHYMAL HYPERECHOGENECITY NOTED.
GALL BLADDER - PARTIALLY DISTENDED. NO CALCULUS SEEN.
IMPRESSION OF LIVER - MILD FATTY CHANGES IN LIVER.

PRESCRIPTIONS: (DIOGNISED AS HYPERTENSION)

ROZUSTAT - 20 mg - non stop after dinner
CLOPILET - A (ASPIRIN INCLUDED) - non stop. after dinner.
STAMILO 2.5 mg. (daily after breakfast)
THYRONORM 50mcg. daily one tablet during morning hours.

I feel weekness regularly especially after 4pm onwards (after 3-4 hours after lunch). Kindly give your second opinion

Fasting blood sugar level is normal since 20 days always less than 90 mg/dl.

Whether chances getting heart attack/stroke ? kindly guide.


My age 57 , Male, Vegetarian - no drinking/no smoking habit. I am having fatty liver since 3 years. Recently i have been hospitalised for Hypertension and above drugs are prescribed and i am taking the above medicines since 20 days continuously as advised by hospital doctor.
Kindly give second opinion.

Category: Neurologist, Medical

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Category: Pediatric Neurologist
 21 Doctors Online

Hi,
Thank you for posting your query at DoctorSpring.com.
I have noted your symptoms and I would like to reassure you that you would not get any serious illness such as her attack or brain stroke.
Clopilet-A and Rosustat tablets would prevent any heart attack or brain stroke in future.
In addition, Rosustat would also normalise your cholesterol levels.
You should also continue your BP and thyroid medications.
Please check the levels of vitamin B12 and D levels and take supplements if they are low.
Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Patient replied :

Respected Sir Thank you for your valuable guidance. In the same hospital, where i got admitted, there is one of our family doctors (cardiologist) who take care of health of my parents; he advised me to take Atorlip-10mg and Ceruvin-A instead of Rozustat 20mg and Clopilet-A. . I am taking Rozustat and Clopilet since 2nd October 2014 and have been advised to take these medications for one month. If i change to Atorlip-10mg and Ceruvin-A, whether it will create adverse effect? or whether i have to give gap of one day or two before starting Atorlip-10mg and Ceruvin-A?
Moreover, this cardiologist has not prescribed any tablet for BP and in addition to Atorlip-10mg and Ceruvin-A, he has advised me to take Pantocid-40mg(gastric problem).
Also, kindly advise me about diet/food strategy to be followed, because i am having constipation problem also ; may be because of these medications/gastric.
At present, i am taking less oil/saltless foods as far as possible since 20 days. My sugar level is under 90mg/dl (fasting) - always . BP varies from 101/76 to 125/87/84. But BP yesterday was 135/96/79. After bowel movement; it reduced to 117/85.

Kindly guide.
thank you Sir,




Kindly guide.


Thank you for getting back.
The alternatives suggested by your family doctor is fine and why are almost similar in efficacy. So, you can change them at once.
Since your BP is normal, at present, you do not need any BP medications.
You should avoid oily and fatty foods and also too much of sweets. I note that you are already taking care of that.
Best wishes,
Feel free to discuss further,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Patient replied :

Thank you very much for your valuable guidance through this forum. I am closing this discussion.

with regards,
LAKSHMNA PRASAD AN



Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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