Does my father need angiography

[bijaybd]

Hello Sir,
My father M A Hamid 65 years old recently having some heart problem and getting tired after few minutes of walking and even if he takes stairs for just 1 floor he feels very tired. He has diabetics from a long time and the last time we checked (10-05-16) HbA1c - result- 10.3%.Plasma Glucose Random : 6.3 mmol/L. He had minor stroke in 2012. Now recently he is saying that he is having heart problems and he don't have any taste in food and can't eat well, can't sleep at night more than 2 to 3 hours, heart is feeling like blocking. We took him to a cardiologists and he said there are problem in his heart, and the heart has blocks. So, he suggest us for some test - echo and chest xray. Below I have given the echo report :

LA - 42mm, LVIDD - 58mm, MVA - 4.5 cm2, Aorta - 37 mm, LVIDS-45mm, ACS - 16 mm, IVST - 12mm, FS- 30%, MV annulus - mm. PW - 07 mm, EF - 38%, Aortic annulus mm

Description:      
LA - Mildly dilated
LV - Dilated, Global hypokinesia seen.
RA : Normal
PA : Normal
MV : Normal
AV : Normal
TV : Normal
PV : Normal
Normal atrioventricular connection with situs solitus.
IAS Intact.
IVS - Intact.
Normal atrioventricular and ventriculoarterial connection.
Two atria & two ventricles.
No Thrombus or pericardial effusion seen.

Doppler study:
Matral valve (0.6-1.3) Velocity - 2.5 mm/s, PPG - 2.4 mmHg, Regurgitation - Trivial.
Aortic valve (1.0-1.7) Velocity - 0.87 mm/s, PPG - 2.6 mmHg, Regurgitation - Nil.
Pulmonary Valve (0.6-0.9) Velocity - 0.8 mm/s, PPG - 2.7 mmHg, Regurgitation - Nil.
Tricuspid Valve valve (0.6-1.3) Velocity - 0.9 mm/s, PPG - 3.9 mmHg, Regurgitation - Nil.

Color Flow Mapping:
Mitral Valve: normal,
Aortic Valve: normal
Pulmonary Valve: normal.
Tricuspid Valve: normal.

ASD - Absent
VSD - Absent
PDA - Absent


Conclusion:
1. Ischemic Cardiomyopathy.
2. Moderate LV systolic dysfunction.
2. MR (Trivial).


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BP - 160/90

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Previous Medicines:
Rivotril 2mg - 0+0+1
Secrin 4mg - 1+0+0
Ecosprin 75mg - 0+1+0
Anglock 50mg - 1+0+0
Omidon 10mg - 1+1+1
Divastin 10mg - 0+0+1


All above medicines will continue and new medicines added by doctor are:
change of Angilock 50mg to Angilock 50 Plus
Pladex 75mg - 0+1+0
Nitrin SR 2.6 mg - 1+0+1
Gerdo 2mg/Paricel 20mg - 1+0+1
Lexotanel 3mg - 0+0+1 (Sleeping pill)
Frulac 20mg/50mg - 1+0+0

At first we thought it might be gastric problem, but after taking gastric medicines and food in control still the problem didn't gone.We are very worried about the block as the doctor said, and later he said we need to go for angiography to be sure about the blocks.  But, we are very nervous is there anything that we need to be worried about.

Please let me know if anything else is needed.

Will be waiting for your reply.

Thanks in advance.

Kind Regards