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Extreme fatigue after ablation
Submitted by Dr T on June 2, 2012 - 8:24am
Question:
I had an ablation on 5-25-12 . I had a complication with a small perforation and pleural effusion. I was in ICU for 4 days. I am home now and have a lot of lightheaded ness when sitting upin bed or rolling over. I also feel my heart speed up. I am extremely, extremely tired. I sleep a lot during the day and cannot do any housework, etc. I called my dr which is 2 hrs away just for reassurance and was told the dr sees his patient's 3-4 months following procedure and gave me a 4 month follow up appt. Are these symptoms normal and any need for concern? The ablation was not completed so I don' t know what was done. Thanks for any advice.
Hi Lynn,
Various cardiac procedures can be complicated by a perforation and/or leakage of blood into the space around your heart that causes all sorts of dangerous symptoms. They include:
I am very concerned about your complaints. You cannot wait for that appointment. Your symptoms are consistent with a collection of fluid around your heart (your pericardium), called pericardial effusion), causing "tamponade", or a persistent pleural effusion (fluid around your lungs).
You need a cardiac echo ASAP.
Hope this helps,
Dr T
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Hi Lynn,
Sometimes the cardiac echo misses a pleural effusion, simply by not "looking" into the R or L chest. Since your heart function is normal at rest, sometimes a stress echo is necessary to detect a small localized fluid collection that only interferes with your heart function during exercise.
Thus, make sure there is no pleural effusion with another (stress) echo. If these are also normal, your fatigue is probably not related to your heart,
Hope this helps,
Dr T
Thank you Dr. T for your concern.
5-25 echo 1 cm anterior pericardial effusion
5-26 echo stable effusion, very mild early diastolic collapse
5-27 echo resolving effusion 0.8 normal function
5-28 echo stable effusion 0.8
5-31 my primary physician did order a stat echo, and the office called and said that I still had the effusion but that it was getting better. The tech said it was 0.5 or 0.6
The report given to me when I left the hospital reads: Early HD compromise based on early right ventricular diastolic collapse and respiratory mitral inflow variation suspicious for tamponade. However, she remained HD stable with BPs 100s-130s systolic, HR 90s. Experiencing significant l sided chest pain consistant with pericarditis, initially controlled with toradol and diluadid, now transitioned to Norco. Discharged in stable condition, follow-up with EP as outpatient (in 4 months!)
I am stil having slight pain in left chest and in neck mostly upon changing positions. Still experiencing lightheadedness and someitmes seeing lights before my eyes. Slight cough.Today, is the first day I've felt good. I read that a person can have further complications following an incident like this. I don't know how much of my concern is simply from fear and the experience. Since the effusion is improving, can I expect this to simply resolve with time? What woud your concerns be at this point? I am scheduled to have a kidney stone procedure later in June, and wonder if I should proceed. I am seeing my primary cardiologist on Monday, but don't expect a thourough examination. Thank you for your comments. lynn
Hi Lynn,
Sometimes the cardiac echo misses a pleural effusion, simply by not "looking" into the R or L chest. Since your heart function is normal at rest, sometimes a stress echo is necessary to detect a small localized fluid collection that only interferes with your heart function during exercise.
Thus, make sure there is no pleural effusion with another (stress) echo. If these are also normal, your fatigue is probably not related to your heart,
Hope this helps,
Dr T
Thank you, Dr. T
I went to my primary care doctor, who did order a stat echo. In the hospital, the initial echo was-1 cm anterior pericardial effusion. Followed by #2 which showed stable, effusion, very mild early diastolic collapse. #3-resolving effusion 0.8 normal function. #4-stable effusion 0.8 The echo I had done on 5-31 was .5 to .6 in size according to the tech. The report they gave me stated "evidence of early HD compromise based on early right ventricular diastolic collapse and respiratory mitral inflow variation suspicious for tamponade. However, she remained HD stable with BP's 100's-130's systolic, HR 90's.
Today is the first day that I've felt good. I still have some pain in my left chest area and neck. Lightheaded when I get up and sometimes I see lights when I sit up. Slight cough and a little pain on my left side. When I got home from hospital, I read that a person can have serious complications following this type of incident. I don't know if I'm over exaggerating things simply from fear and the recent experience. Since the effusion seems to be getting better, should I expect that to continue and simply resolve? I am scheduled for a kidney stone procedure later in June and am fearful to have it. (or anything for that matter) Thank you for your help.
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