Dear doctor, I am a 79 years old man. I am neither a diabetic nor hypertensive. I went for heart evaluation. The study revealed the following. total Cholesterol: 243 mgs/dl Direct LDL: 162 mgs/dl Non HDL Cholesterol: 191 Potassium: 4.64 mEq/L I never had BP before. The doctor has advised Amlong 5 mg once a day and Ecosprin AV once a day and Seloken 25 once a day. What is the diagnosis. I went there mainly because I felt that my heart rate was going very low especially in the times when I rest like reading newspaper or watching TV. I am a very poor eater. The hospital doctor has written Sinus Bradycardia, Sclerotic aortic valve mild AR, Normal chambers, normal LV function (EF 60%) and no RWMA. Can you please enlighten me on this? Thanks in advance.

Dr. Sameer MehrotraCardiologist19yrs exp

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1) Your cholesterol is high and at your age we can start low dose statin like atorvastatin 10 mg once daily along with diet change as well daily morning walk for 30-40 mins which should take care of the cholesterol issue. 2) You do not need ecosprin since you do not have diabetes and hypertension unless there is any previous history of heart blockages. 3) With regard to your problem for which you went to the hospital i.e. Low heart rate, even though you have not mentioned how low the heart rate is, your Echo report mentions sinus bradycardia which is medical term of low heart rate, so what we need to understand is that is this low heart rate really leading to any problems or is it just your normal heart rate for that you will need 3 tests - Ecg, TMT and 24 holter these 3 tests will tell us about your normal heart rhythm the impact on it on exertion and 24 hr pattern of your heart rate and accordingly further plan of action can be decided. 4) I donot know if you were previously on seloken or has it been recently started, but it should be stopped since you already have low heart rate and seloken leads to decreased heart rate. In case you were taking it previously then please stop it, wait for 3-5 days and then get the above mentioned tests. 5) Also please understand that heart rate is normally less when resting and sleeping than it is when we are active. 6) Your Echo reports shows your heart function is normal and there is slight calcification at one of the valves but it is not causing any impact to you so no need to worry, you can just get an echo repeated annually. 

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