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Follow up question Extreme fatigue after ablation

Question: 
Dr. T:Thank you for your response. I am including more info:5-25: 1 cm anterior pericardial effusion5-26: stable effusion, very mild early diastolic collapse5-27: resolving effusion 0.8 normal function5-28: stable effusion 0.85-31: home, primary care ordered stat echo. Informed that effusion is better, app: 0.5Records given to me at discharge, state: Early HD compromise based on early R ventricular diastolic collapse and respiratory mitral inflow suspicious for tamponade. However, she remained HD stable with BPs 100s-130s systolic, HR 90s. Discharged in stable condition. Follow up with EP physician. (in 4 months!)Today is the best day in 8 days. I still have some left sided pain and a little in my neck. I read that a person can have serious complications following an incident like this for up to 4-6 weeks later. Since my effusion  seems to be resolving, will it simply continue to go away? What would your immediate concerns be? After an experience like this, I am fearful and on edge that something more is going to happen. I am still lightheaded and sometimes see bright lights when I sit up. I have a kidney stone procedure scheduled for later in June and wonder if I should proceed? I will see my primary cardiologist on Monday, but he doesn't even have the reports from this procedure. Any further feedback would be appreciated. thanks. 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.

Pleural Effusion after CABG

Question: 
My husband is 51 and had triple bypass right before Christmas.  His only symptom of blockage was a minor, yet recurrent, pain in his chest on exertion.  Needless to say, we were shocked.  He has never smoked and only weighs 152 pounds.  His cardiologist says it is 99.9% family history since his dad died in his 40's after having a stroke.The CABG went well, but he developed a pleural effusion after surgery on both sides.  He has been in and out of the hospital multiple times since.  He has had two thorocentesis procedures and is in the hospital now for the second time with double pneumonia.  He feels good, but the hospitalist won't let him come home because he prefers i.v. antibiotics.  The cardiologist said there is not enough fluid to drain this time, but we asked for a pulmonologist since my husband is literally on his 4th day of being in the hospital this time.  The pulmonologist wants it drained again because he said there is a high likelihood of repeated infection if it continues to sit there.No one can explain what is happening.  We are continually told they are not sure what causes this but assure us that it will go ahead.  All tests for congestive heart failure are negative so far.  We have three young children, and my husband has been working since his recovery.  But, we don't know how long he will be allowed to miss so much work.  We have a hospital specific HMO, so another opinion is not an option unless we pay for it...which we are considering.  Anyway, I thought you might have some thoughts. It seems like my husband's case is quite the mystery.Thanks so much for your time.

Hi Lisa,
The combination of fluid around the lung(s) and a collapsed lung happens occasionally and i have written about this here. Are his surgeons no longer involved with the treatment? I ask this because other doctors are frequently not aware of this problem (sometimes called Dressler's syndrome or post cardiotomy syndrome).

When the lung collapses, it frequently becomes infected, thus the treatment needs to involve lots of chest PT to help re-expand the lung to normal, antibiotics, and occasionally anti-inflammatory and steroid meds.
Hope this helps,
Dr T

Collapsed lung and fluid around the lung after heart surgery

Question: 
hello sir, this is a 55 year old female who underwent CABG 2 months ago who is also a known asthmatic, who got complications like mild left lung collapse and effusion which was treated with physiotherapy, where the patient was feeling better and x-rays showed resolving symptoms. she later had fever with cough and sputum for one week, fever subsided but cough was continuing with shortness of breath for 30 minutes after hot water bath, feeling breathless during nights and efficacy of breathing has been reduced, so kindly tell me what could be the problem behind these symptoms?

Hi Anitha,
This condition is a complication of the operation. It is called atelectasis and is frequently associated with a pleural effusion (collection of fluid around the lung). One may cause the other.
Hope this helps,

Dr. T

 

My Legs feel heavy and tired after walking and exercise

Question: 
I RECENTLY HAD A CT SCAN AND IT READ THAT THERE IS SOME CALIFICATION IN THE AORTAILIAC BIFURCATION.  IS THAT SOMETHING THAT NEEDS TO BE ADDRESSED FURTHER OR IS IT NORMAL FOR SOMEONE AGE 51? MY LEGS DO FEEL HEAVY AND TIRED AFTER WALKING OR DOING ANY EXERCISE.  THANK YOU VERY MUCH FOR ANY HELP.

Hi Teresa,
Your symptoms and the CT scan results are suggestive of a blockage in your aorta called Leriche Syndrome, which often occurs in patients with abnormal cholesterol, atherosclerosis, hypertension and heavy smoking.

Is my husband's aorta too large?

Question: 
My husband has been having his aorta watched. Two years ago, his ascending aorta measured 3.8 cm. Two years later it is still 3.8 cm- has remained the same. One doc is calling it an aneurysm, another thinks it might just be normal for my husband's size- 6'2'' tall 210 pounds, no high blood pressure--this was an incidental finding. In any event, it still worries me a great deal. Which scenario is more likely? Can this measurement fall within the normal range? Does my husband need to be monitored for life and should our children be screened for this problem as well.Thank you.

Hi Lisa,
At 3.8 cm your husband's aorta is a little large but not enough to do more than follow it regularly at this point, unless he develops chest pain symptoms.
Read more here:
http://www.cardiachealth.org/aneurysms
http://www.cardiachealth.org/thoracic-aortic-aneurysm
Hope this helps,
Dr T

Concerns about the use of Pradaxa for stroke prevention

New reports are raising concerns about Pradaxa, because of serious and sometimes fatal bleeding associated with the drug.  

Circulation problems in my arm

Question: 
HI. I dont know you are the right person but here it is in Winter season my hands got cold specialy right hand.I dont know whats the matter . i live in pakistan and i know if go to doctor he,ll just give me some medicine without proPer MEDICAL test so please tell me is there any problem with ME  or should i have some medical test ?        

Ask your doctor to examine the circulation in your arm and hands/finger tips. If abnormal, it can be detected with a proper examination and if needed, some tests. W/o that information I cannot answer you.
Hope this helps,
Dr T

Can you get lung cancer after only 4 years of smoking?

Question: 
I have been smoking for the past 7 years. What are my chances that I will get lung cancer?

Your chance of getting lung cancer after only 4 years are low. Lung cancer is caused by many factors that include what you smoke, how much and how long you have smoked, family history for cancer and many environmental factors. It is also the cause of many other diseases that include emphysema and heart disease and stroke, as well as many other illnesses.

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