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Suggest Treatment For Difficulty Breathing And Swollen Face And Neck In A Heart Patient
Question: My Mom has a pace maker history of stroke right sided weakness and aphasia. Was in the hospital for fever and wheezing and was diagnosed for pneumonia and congestive heart failure. its been two weeks now she is breathing heavily with wheezing and her face and neck is swollen, what should I do please help?
Brief Answer:
Following answer to your queries...
Detailed Answer:
Hi and thank you for asking!
I'm sorry with the situation your mother is in.
My opinion is that your mother health is compromised from pneumonia and heart failure which are manifested with fever, dyspnea and edemas. With such a severe clinical presentation at my clinic I would have done directly the following examinations:
- blood work (including blood count, BUN and creatinemia, electrolytes e.t.c). Renal failure is a common finding in patients with heart failure and should be excluded. A normal BUN and creatinemia exclude renale failure.
- blood gas analysis
- Chest X ray
- sputum culture
- cardiac ECHO
- heart monitoring (we would have put her on close rhythm monitoring)
This will help for the evaluation of severity of congestive heart failure and pneumonia.
If she was my patient I would have treated her with:
- Antibiotics (based on sputum culture results)
- Diuretics, the most common used drugs are loop diuretics (such as furosemide)
- Spironalactone
- Nebivolol (it's the most selective beta blockers and has minimal side effects on pulmonary function)
- Digoxin (if she has atrial fibrillation)
- Warfarine
However you should discus about the treatment with her doctor, because he has all the needed data to decide the best treatment for her.
Wish you and your family health!
Dr. Shehu
Following answer to your queries...
Detailed Answer:
Hi and thank you for asking!
I'm sorry with the situation your mother is in.
My opinion is that your mother health is compromised from pneumonia and heart failure which are manifested with fever, dyspnea and edemas. With such a severe clinical presentation at my clinic I would have done directly the following examinations:
- blood work (including blood count, BUN and creatinemia, electrolytes e.t.c). Renal failure is a common finding in patients with heart failure and should be excluded. A normal BUN and creatinemia exclude renale failure.
- blood gas analysis
- Chest X ray
- sputum culture
- cardiac ECHO
- heart monitoring (we would have put her on close rhythm monitoring)
This will help for the evaluation of severity of congestive heart failure and pneumonia.
If she was my patient I would have treated her with:
- Antibiotics (based on sputum culture results)
- Diuretics, the most common used drugs are loop diuretics (such as furosemide)
- Spironalactone
- Nebivolol (it's the most selective beta blockers and has minimal side effects on pulmonary function)
- Digoxin (if she has atrial fibrillation)
- Warfarine
However you should discus about the treatment with her doctor, because he has all the needed data to decide the best treatment for her.
Wish you and your family health!
Dr. Shehu
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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