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DrRussMd, Other
Category: Cardiology
Satisfied Customers: 65671
Experience:  Board certified doctor, internal medicine/integrative medicine/advanced training in hormone therapies
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I was diagnosed with Tako Tsubo Cardiomyopathy in July when

Customer Question

I was diagnosed with Tako Tsubo Cardiomyopathy in July when I was abroad. I now have questions about the medication. Most recently I have been taking Ramipril 2.5mg, Bisopropol 1.25 and continuing with the Simvastatin 40mg I have taken for some years for preventative reasons.
Over the last three months or so I have found I have been increasingly developing a skin rash or eczema on my face and on one of my hands. My GP has given me E 45 and Aqueous cream but these only relieve the condition slightly. I had a cardiac MRI on October 9th but have not yet received the results. I spoke to the Dr in charge of the MRI about the skin rash which he thought was most likely caused by the Ramipril. He suggested that an ARB such as Candesartan might be an alternative. I have not yet asked for an alternative prescription to the Ramipril as it seemed sensible to have the results of the MRI first. However I have stopped taking the Ramipril and the rash is gradually decreasing. I realise though that this may not be a sensible action in terms of the effect on the heart but the rash was considerably bothering me.
There is one other piece of information that may be relevant to the situation. I am not sure that the cardiac team know of this and have only realised recently that it may be relevant for them to know. I have Glaucoma and am prescribed Ganfort for this condition which has been working fine and with no side effects. I do note however that there is a warning in the accompanying pamphlet not to take Ganfort if one has certain heart problems. I do not wish however to stop this as it has been working well and another type of drop was not successful in reducing the eye pressure. I do wonder though if my reaction to the Ramipril ( or possibly to the Bisopropol) might have any connection with the fact that I am already taking Ganfort.
Are you able to give me any advice:
1.In your view do you think I need to continue with Bisoprolol and with an ACE inhibitor? If the latter what would you suggest in place of Ramipril?
2.Is there likely to be any significance in the fact that I am already on Ganfort eye drops?
I was trying to get hold of the consultant cardiologist last week without success to discuss these matters not least in the light of the MRI scan. I don't know what country you are in but in England and on the NHS such communication problems are not uncommon.
Submitted: 4 years ago.
Category: Cardiology
Expert:  DrRussMd replied 4 years ago.
Hello from ja.
1. Yes. this stops heart failure from progressing. Until you see the MRI, you should continue. The ACE inhibitor can be replaced by another ACE, or even by an ARB.
2. No, I do not think the glaucoma medicine is relevant unless you are not improving. You are talking about a rare problem that is probably not pertinent here.

Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Expert:  DrRussMd replied 4 years ago.
Please use reply
I have you in the reply box but no post