Cardiologist recommandation in Bangkok

[drenddy]

Hi there

 

I've searched the forum and found out two names, Dr.Koonlawee Nademanee og Dr.Visuit Vivekaphirat.

 

It's for my wife.She has symptomatic PVC's - shortness of breath mostly.Something new, she was at Sukhumvit Hospital the other day.

 

The reason, why I ask about these two cardiologists, is that I would like an second opinion, not because we doubt Sukhumvit Hospital doctor's assessment, but my wife told me they discussed treatment options and so on.

When they talked about medicin, they agreed (as far as I understood from my wife), that she should try Flecainide.I said to her not to take it, until we have a new doctors opinion.

 

From for short search on Dr.Google : this medicin is to be tried only after other medications have failed and, here in Denmark (I reside in Denmark), it normally requires admission, when to start on this medicin.

 

I don't have too much experience with doctors in Thailand, but am I overreacting, if I say thai docs too often and too soon recommend (strong) medicin? I, myself, work in the health system (mental health) and I remember, when one not so closed family member of my wife, went to psychiatrist.From my opionion it was clear BPD (borderline personality disorder) and the poor girl was put on antipsychotics (not that this is unsual) and benzodiazepines, already from the first meeting, rather than emphasize on therapy - of course, this single episode does not mean that this is typical for thai doctors, but you get my point.

 

So...

 

I don't expect any different assessment from the initial one, done at Sukhumvit Hospital, but a new take on medicin - and need for it at this moment.

 

And what fee should we expect for a consultation with one of these two doctors? If it is about few thousands THB, there is no issues - at least we get to talk with top cardiologists (as mentioned on aseannow), but if it will be around 10 k, then perhaps no need to spend money on something, we already know.

 

I think they will perform new ECG..or can use that one from Sukhumvit.

 

[SLOWHAND225]

She's lucky to have you. 
Smart move, the second opinion and having looked up the medication. Most people are just sheep.

[Sheryl]

you need a cardiologist specializing in arrythmia management/electrophysiology. Prof. Koonlawee Nademanee is (and tops in the filed), Dr. Visuit is not (though otherwise excellent).

 

If you see Prof. Koonlawee at Bumrungrad the consultation will be a few thousand baht, but any tests will be additonal. The full WEKG done at Sukhumvit hospital will be OK as far as that goes,  but they will likely also want at least a rhythm strip (like an EKG but longer in duration) or possible a 24 hour+ monitoring which can be done as outpatient using a portable device, this is to get a full picture of the heart's electrical activity and rhythms.  I don't know the cost of this.  In addition, they might or might not advise other tests to try to identify cause of the PVCs. If any tests have already been done, be sure to bring the results them along.

 

In terms of cost, the most affordable option (but not the most convenient) would be to go to the specialty center at Chulalongkorn Hospital Cardiac Center

 

  http://www.chulacardiaccenter.org/en/about-us

 

Cardiology, Physiology and Cardiac Laboratory

Monday – Friday, 08.00 – 16.00 hrs.

Bhumisirimangalanusorn Building, 4^th Floor, Zone D

 

Try if possible to see Dr. Nithi Tokavanich there.

 

She should avoid tobacco, caffeine and alcohol (or at least minimize the last two). Also, absolutely no diet drinks/teas/pills. In fact if she has been taking such, might try stopping them first before doing anything else as they alone can cause this (and even more seriosu arryhtmias). 

 

[drenddy]

35 minutes ago, Sheryl said:

you need a cardiologist specializing in arrythmia management/electrophysiology. Prof. Koonlawee Nademanee is (and tops in the filed), Dr. Visuit is not (though otherwise excellent).

 

If you see Prof. Koonlawee at Bumrungrad the consultation will be a few thousand baht, but any tests will be additonal. The full WEKG done at Sukhumvit hospital will be OK as far as that goes,  but they will likely also want at least a rhythm strip (like an EKG but longer in duration) or possible a 24 hour+ monitoring which can be done as outpatient using a portable device, this is to get a full picture of the heart's electrical activity and rhythms.  I don't know the cost of this.  In addition, they might or might not advise other tests to try to identify cause of the PVCs. If any tests have already been done, be sure to bring the results them along.

 

In terms of cost, the most affordable option (but not the most convenient) would be to go to the specialty center at Chulalongkorn Hospital Cardiac Center

 

  http://www.chulacardiaccenter.org/en/about-us

 

Cardiology, Physiology and Cardiac Laboratory

Monday – Friday, 08.00 – 16.00 hrs.

Bhumisirimangalanusorn Building, 4^th Floor, Zone D

 

Try if possible to see Dr. Nithi Tokavanich there.

 

She should avoid tobacco, caffeine and alcohol (or at least minimize the last two). Also, absolutely no diet drinks/teas/pills. In fact if she has been taking such, might try stopping them first before doing anything else as they alone can cause this (and even more seriosu arryhtmias). 

 

 

Much appreciated.

 

As for tests, she only did ECG at Sukhumvit Hospital.

 

What you describe, in terms of further testing, sounds good, but being at Bumrungrad, I am afraid the costs would go further up.

 

I think we will try contact both Bumrungrad and Chula (link does not work)

 

 

[drenddy]

1 hour ago, Sheryl said:

 

 

 

Sorry to bother you again.

 

I found these screening packages :

 

      https://www.bangkokhospital.com/en/bangkok-heart/package/atrial-fibrillation-screening

 

      https://www.vejthani.com/packages-and-programs/heart-arrhythmia-screening-package-2024/

 

      https://www.thaimedicsbh.com/Package/Health-Check-up/Cardiacarrhythmia-Screening

[Sheryl]

Those packages are useful as an indication of what Holter monitor screening might cost (much of the packages, she would probably not need). Looks like under 10K. 

 

My advice is not to waste time with such packages, see doctor first to see exactly what sort of testing is recommended.

 

You can't contact Chula in advance, have to go in person, it is a government hospital (hence the "less convenient" aspect).  But it will certainly cost less, though multiple trips may be required what could be done in one at a private hospital