Talk to Cardiologist on Post CABG Heart Problems
Asking for Father, Male, 62 years old, Dipalpur
Aslam o Alikum. My father is suffering with problems of flat laying back. He is a CABG patient a year back. His weaknesses is increasing day by day. He also has problems of svere vometing sometimes. At present he is using merol , ascard , nclot. rovista, lasics replaced by spiromide, stomacol, at his heart attack time a year back his EF was just 15% , after cabg we didn't check it. main problem is he cant lay back. he had not slept by more then a week. he cant ly back. as he try to lay down he says i feels very irregulations in my heart area please please suggest me something.
walekum Asalam, he is patient of ischemic cardiomyopathy, can you tell the blood pressure and heart rate of him.
Dr. Abdul Hafeez - Cardiologist
MBBS, Diploma in (Cardiology) | Karachi
these are symptoms of worsened heart failure. given pre CABG Ef of 15% this is very likely to happen. He needs hospitalization and management of decompensated heart failure.
Member
sir blood pressure is 120/80.
Today's 15/04/2020 fresh echocardiography shows severe LV systolic dysfunction.
EF 25%.Segmental wall motion analysis shows hypokinesia apical IVS, basal antero-septal and anterior segments. Dilated right vertical with mild RV systolic dysfunctions. severe TR. Moderate pulmonary hypertension.
After physical exam today respected cardiologist stop spiromide and start lasix. 40mg twice a day.
Tab Neo.K 500mg. three times a day.
along with previous medication i.e. noclot.merol.rovista.dexxoo.stomacol.
Thanks to all for very very precious time.
1 month ago
WoA ! Based on the history your father’s heart seams to be very weak and he is retaining water in his lungs. He will need a repeat echocardiogram . You need to consult your cardiologist. Meanwhile at home he should be on low(nil ) salt diet. And his fluid content should be restricted.( < 1.5 Ltrs / day ) even less. Based on the latest echo report, your cardiologist can advise you what further treatment options are available. Thanks
Need to know one thing ask him clearly why he can’t lie straight due to shortness of breath. And dose of spiromide.
Member
mam , main issue is shortness of breath, suffocation while laying flat.
blood pressure is 120/80.
Today's 15/4/2020 fresh echocardiography shows severe LV systolic dysfunction.
EF 25%.Segmental wall motion analysis shows hypokinesia apical IVS, basal antero-septal and anterior segments. Dilated right vertical with mild RV systolic dysfunctions. severe TR. Moderate pulmonary hypertension.
After physical exam today respected cardiologist stop spiromide and start lasix. 40mg twice a day. As he observed excess water in tummy area as tummy was pumped up.
Tab Neo.K 500mg. three times a day.
along with previous medication i.e. noclot.merol.rovista.dexxoo.stomacol.
Thanks to all for very very precious time.
1 month ago
Can you tell me the current bp and pulse? Also ask him if he is feeling difficulty in breathing while lying flat?
Member
sir blood pressure is 120/80.
Today's 15-04-2020 fresh echocardiography shows severe LV systolic dysfunction.
EF 25%.Segmental wall motion analysis shows hypokinesia apical IVS, basal antero-septal and anterior segments. Dilated right vertical with mild RV systolic dysfunctions. severe TR. Moderate pulmonary hypertension.
After physical exam today respected cardiologist stop spiromide and start lasix. 40mg twice a day.
Tab Neo.K 500mg. three times a day.
along with previous medication i.e. noclot.merol.rovista.dexxoo.stomacol.
Thanks to all for very very precious time.
1 month ago
Will need hospitalisation and further injections of lasix along with urine catheter.
Dr. Muhammad Muneeb - Cardiologist
MBBS, FCPS | Lahore
I think he is having chronic heart failure, requiring hospitalization and treatment with diuretics as well as other heart failure therapy . We need to check his EF as well.
Member
sir he is on diuretics lasix injections 40mg. EF 25% according to yesterday's fresh echo.
after using lasix injections he begans to lay flat.
Thanks to all respected doctors.
1 month ago
Member
Sir blood pressure is 120/80 .fresh echocardiography shows severe LV systolic dysfunction.
EF 25%.Segmental wall motion analysis shows hypokinesia apical IVS, basal antero-septal and anterior segments. Dilated right vertical with mild RV systolic dysfunctions. severe TR. Moderate pulmonary hypertension.
After physical exam today respected cardiologist stop spiromide and start lasix. 40mg twice a day.
Tab Neo.K 500mg. three times a day.
along with previous medication.
1 month ago
But he needs to be in contact with a Cardiologist
1 month ago
Dr. Feroz Memon - Cardiologist
MBBS, Dip (Cardiology), FACC | Lahore
His heart is very weak & he needs to increase his dose of spiromide by 40 mg twice a day. Need to see his recent ecg & echo & what’s his bp? Also needs blood tests like CP, urea , creatinine & HbA1c.
Would like to see his pulse through heart rate apps for rate and regularity and blood pressure, respiratory rate and temperature. A video chat to see his neck veins to assess for fluid overload. An ecg with a long lead will help. If possible check his RFTs and electrolytes from a reliable laboratory. Should stop tab ascard as it can cause vomiting by irritating his stomach. The other possible cause for vomiting may be impaired renal function. Elevate the head end of the bed. Switch back to lasix from spiromide. Start essomeprazole 20mg od. Will decide on increasing the lasix, adding nitrarate and ACEi after the clinical and lab data with echo if possible.
treatment plan for your father .
ascardplus 75/75 1+0+0
carveda 6.25 1+0+1
valsar-s 50 1+0+1
lasix 40mg 1+0+0
eplar 50mg 0+1+0
stat A 10mg 0+0+1
vestral mr 1+0+1
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Member
sir blood pressure is 120/80.
Today's 15-04-2020 fresh echocardiography shows severe LV systolic dysfunction.
EF 25%.Segmental wall motion analysis shows hypokinesia apical IVS, basal antero-septal and anterior segments. Dilated right vertical with mild RV systolic dysfunctions. severe TR. Moderate pulmonary hypertension.
After physical exam today respected cardiologist stop spiromide and start lasix. 40mg twice a day.
Tab Neo.K 500mg. three times a day.
along with previous medication i.e. noclot.merol.rovista.dexxoo.stomacol.
Thanks to all for very very precious time.
1 month ago