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Suggest Treatment For Bronchitis Cough After Angioplasty

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Posted on Tue, 25 Aug 2015
Question: Hi Doctore, my dad has had a angioplasty 15 days ago, his doctors implemented two stents around his heart. He got both metal stents coated with medicine, and now is taking Brilique whit cardipirin (aspirin), which I've learned is usual procedure for a year. But for a week now he has had a terrible bronchitis cough,ever since he came out of hospital and it just got worse and worse. He is diabetic on injections, for years now Novomix is one he takes. However yesterday he was admitted into hospital as he was feeling very faint; he didnt sleep for a few days from the cough and they took his blood. the d-dimer was more than 3000; showing that he has acute thrombosis, but I don't understand how as he has been taking all the prescribed medicine strictly. They have done a few tests again after he was admitted and the d-dimer went a bit down, they didnt change his medications?? Why? They did an ultra sound of his arteries around heart lungs and brain and they were fine. And they haven't found the bloodclog, he just got his lungs x-ray and its fine. The problem is he still feels faint and not well, though a bit better I guess because of antibiotics? Are they maybe missing something? Please write me your opinion? Maybe his legs need to be scanned or something else? He is 63 years old.
doctor
Answered by Dr. Lilit Baghdasaryan (26 minutes later)
Brief Answer:
Need more information

Detailed Answer:
Hi,
Welcome to HealthcareMagic

I would like to ask some questions before answering
1. did they performed a CT angiography of pulmonary artery
2. Did your father has any comolaints related to lower limb, such as soreness, pain, change in color
3. What examination exactly do you mean by sonography of heart and lung vessels
4. Do you have copies of examination to attach

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (41 hours later)
They preformed ultrasound/sonography to all the arteries leading to his heart, to his lungs and to his brain. I do not know what is CT angiography and I do not think they have preformed that.
I do not have any documentation as all is with him and all is in Serbian.
He is now feeling better and is home, now his d-dimer is 500 slowly going down but still not stable.
I am worried because he is a diabetic and he does not feel pain as normal patients would. His legs had lost the swelling he had in recent years and lost 8 kg in three weeks, or since the surgery.

Please send me your opinion on what could have caused such results or if you think the doctors might be missing something?
doctor
Answered by Dr. Lilit Baghdasaryan (34 minutes later)
Brief Answer:
Welcome back

Detailed Answer:

CT angiography is the gold standard examination for the determining pulmonary artery thrombosis (thrombus in the lung arteries).

With ultrasound they would detected any big thrombus. In case of small ones, even if they are not detectable, they are not dangerous and usually resolve easily.

It is very good sign, that D-dimer decreased up to 500.
You should know, we have D dimer elevation in many conditions, so it is not obligatory to be thrombus. It may be a simple pneumonia.

He is recovering quite quickly, so my advise will be to continue his doctor's prescriptions.
In case if he doesn't receive anticoagulation, I would advise him to talk with his doctor to discuss the risks and if there is a need for anticoagulation.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (2 days later)
Dear doctor,

Thank you for your answer. I think he is doing better now. He was under antibiotics and beredual inhaler aspirator. He had some more medicine changed and he saw a pulmonologist specialist, as the doctors at the intensive care concluded he has obstructive bronchitis. He performed an spiromethry and my dad blow 63 out of 64, everybody was amazed how great his lungs were doing after this antibiotic treatments.
What worries me now is, that he is still a bit weak, as if he still doesn't have the strength he had before the stent surgery. He gets tired after climbing to a second floor, where we live, or for example can walk for so long maybe 1 km XXXXXXX and than he get tired.
The doctors told us that after stent surgery he should have more power and generally be more at ease with physical activity.
What my question is, is he going to feel like this always now or is it just the recovery phase and how long is the recovery phase generally for people of 63 after stent surgery that have diabetes 2?
Regards,
doctor
Answered by Dr. Lilit Baghdasaryan (36 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
My dear,

You shouldn't worry. He is recovering now and can have some weakness. The duration of recovery it quite individual, can be up to a month.

Regards,
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Suggest Treatment For Bronchitis Cough After Angioplasty

Brief Answer: Need more information Detailed Answer: Hi, Welcome to HealthcareMagic I would like to ask some questions before answering 1. did they performed a CT angiography of pulmonary artery 2. Did your father has any comolaints related to lower limb, such as soreness, pain, change in color 3. What examination exactly do you mean by sonography of heart and lung vessels 4. Do you have copies of examination to attach Regards,