Q: I am 76 years old and suffered a heart attack and underwent a bypass surgery two years back. An echo was done last year with EF at 50%. Early this year, I started complaining of breathlessness and heaviness in the head. Another Echo later and the EF is now 30%. The cardiologist administered me Dobutamine Injection and prescribed Lasix (1/2 tab) and Fruselac (1/2 tab). Although the breathlessness has come down, the heaviness in the head continues. What else can be done? Can I be examined at a better hospital for better results?

A:Your headache cannot be explained by your cardiac problem. You are not on nitrates which may produce headaches. You should consult a neurologist about this. The decrease in the pumping function occurs slowly after a heart attack. This is called remodeling and to some extent is decreased by ACEI/ARBs (eg. Tozar) and B-Blockers (eg. Carvedilol, Nebivelol). However, you may need to check the patency of the grafts by a stress nuclear test or 64 slice CT angio or a Dobutamine Echo which will be available in Bhubaneswar. For your constipation substituting breakfast to a large extent by fruits and sprouted legumes will give you enough fibre to prevent constipation. Many people complain of headaches when they are constipated.