Better to exhaust non- invasive modalities first

Q My father is 56- years- old, and he recently had his annual heart check- up done. The cardiologist said that the ECG was not normal, and he did not allow him to complete the treadmill test. The downward pointing valleys on the ECG were longer than they should be. The doctor recommended I should also get an angiogram, but because it is an invasive procedure, I asked for an alternative, and he suggested a radioisotope scan. How do I decide which is the best procedure for me? I have a family history of heart disease and my previous angiogram showed a 20 per cent lesion. — Sai Prakash

Based on your account, you should ideally undergo an angiogram in view of your family history and the finding of a 20 per cent lesion. But, as your cardiologist has suggested, it may be better to exhaust noninvasive modalities first. An isotope scan will reveal any area of heart muscle that is ischemic, and indicate whether or not you require a formal invasive angiography. It is best to take the final call after a discussion with your treating cardiologist.

— Dr G. Surya Prakash, senior consultant cardiologist

Q I am a 34- year- old male suffering from urinary incontinence. I searched the internet and got to know that the problem is more prevalent among women and the elderly. Whenever I sit down, I experience urine leakage even though I consume very little water. What is the cause of this? — Anonymous

I suggest you see a urologist. This does not appear to be a serious condition. Sometimes, a drop of urine remains trapped in the urethra, and that’s what trickles out. If you have a sense of urgency, then it is important to rule out a neurological cause. — Dr U. Srinivas,

senior consultant urologist and kidney transplant surgeon