### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
my wife Indira age 53y. She is in menopaze. She is house wife .Both are ceasarian delivery since 6 years she had a diabetic and her parents are diabetic. at present she is using tab. JOHNMET 50/500. HBA1C ..7.1... H.B in blodd is 13 grams. She is oftenly getting chest , throat and head tightness. She is suffering in sometimes rapid heart beating . ECHO, Pulmonary and ECG shows normal. In Xray denotes full gas said by one MD. So she is suffering rapid heard beating due to gas only. We used such doctor medicine for 10 days no changes in patient problems. Yesterday we visited another MD cardiology specialist has took another ECHO and said normal. But he ultimately says it is not gas problem and heart is not taking blood promptly from system so you can use medicines for 15 days. In both doctors said no BP. SINCE 5 YEARS SHE IS SUFFERING BURNING PROBLEM BELOW THE RIGHT BREAST. THERE IS NOTHING WILL BE IN SCAN.SINCE 40 DAYS WE TOTALLY STOPPED SALT IN CURRIES AND CURD RICE. SHE USUALLY TAKE VEGETABLE JUICE MORNING, AND MOST OF DAYS COOKING PULSES AS BREAKFAST. REGULARYL SHE CONSUME MINIMUM 4 LETERS OF DRINING WATER AND BREATHING EXERCISESKINDLY GIVE ME YOUR VALUABLE SUGGESTIONS FOR TIGHTNESS OF CHEST,THROAT AND HEAD. At present 2nd MD prescribed medicines are..ROSUVASTATILN CALCIUM IP 2.ANGISPAN -TR (timed release capsules of nitrogylcerin) 3.NIKOS 5(Nicorandil tables ip 5 mg 4.ETIZOL PLUS 5 (Etizolam & escitalop) 5.RANCAD (Ranolazine extended release tab.500mg) 6.IVAMAC(Ivabradine tab). more medicines? Differ opinions. g.v.ramulu chirala.

### output:

Hi, your question has a complex answer and therefore the delay in some medical answer it, but I'll try to help you. The overall picture you describe suggests that doctors are treating his wife to severe angina. Angina is caused by a significant obstruction in one or more coronary arteries. To confirm these obstructions is necessary to do a coronary catheterization and thus organize a definitive treatment. There are four forms of treatment for patients with blocked coronary arteries:1- Clinical treatment: Made with medications that reduce metabolism and oxygen consumption of the heart muscle, as well as medications that dilate these arteries.2- Coronary Angioplasty: It is usually used for patients with one or two obstructions in arteries and consists of placing a stent device at the site of obstructions by facilitating local blood flow.3- surgery for revascularization of myocardium: Used for patients with unfavorable obstructions' angioplasty, with better results in the long term in relation to the placement of stents.4- Cardiac transplantation: It is only indicated in extreme cases, when none of the above treatments are possible or effective, associated with significant worsening of cardiac function. It is the least common treatment used. If the optimal medical treatment is not working well, the ideal is to evaluate the possibility of using one of the other alternative described above. Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.