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Suggest Treatment For Hemiparesis
Question: Hi Doctor,
My mom(48 yrs) had suffered from right side hemiparesis 7 months ago (suff from Hyper tension from a decade). later found that she has been suffering from sever lv dysfunction and global hipokinesis through 2D echo. Recently her bp went to 60/40 then doc suggested for holter study..based on holter readings doctor said too many ectopic beats and advised for ICD. I have asked doctor to give us time.mean while he gave cordarone tablet but I looked up onlinethere are many adverse effects(common) of this tablet like losing of eyesight ,hypothirodism and brachycardia. Are there any sideeffects of icd can it be fitted to a brainstroke patient. pls advise.
My mom(48 yrs) had suffered from right side hemiparesis 7 months ago (suff from Hyper tension from a decade). later found that she has been suffering from sever lv dysfunction and global hipokinesis through 2D echo. Recently her bp went to 60/40 then doc suggested for holter study..based on holter readings doctor said too many ectopic beats and advised for ICD. I have asked doctor to give us time.mean while he gave cordarone tablet but I looked up onlinethere are many adverse effects(common) of this tablet like losing of eyesight ,hypothirodism and brachycardia. Are there any sideeffects of icd can it be fitted to a brainstroke patient. pls advise.
Brief Answer:
Need details
Detailed Answer:
Hi
Thanks for your query on HealthcareMagic.
There are few confusions in the Descriptions. First and foremost why was BP so low? Is ICD advised only based on the Holter Report? Is the plan only for ICD or CRT and ICD? How long has she been treated for heart failure? Has she under gone angiogram and ruled out blockages as cause for her blockages?
If all these have been taken care and if its decide she needs and ICD its ok to go ahead with it in the clinical picture you have described. Can be done in the back ground of months old stroke that's no issue. Short of ICD Cardarone is the only option though it has side effect one need to monitor and take care except for lung fibrosis all others can be detected early and can be prevented.
Dr Koregol
Need details
Detailed Answer:
Hi
Thanks for your query on HealthcareMagic.
There are few confusions in the Descriptions. First and foremost why was BP so low? Is ICD advised only based on the Holter Report? Is the plan only for ICD or CRT and ICD? How long has she been treated for heart failure? Has she under gone angiogram and ruled out blockages as cause for her blockages?
If all these have been taken care and if its decide she needs and ICD its ok to go ahead with it in the clinical picture you have described. Can be done in the back ground of months old stroke that's no issue. Short of ICD Cardarone is the only option though it has side effect one need to monitor and take care except for lung fibrosis all others can be detected early and can be prevented.
Dr Koregol
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doctor,
A few days back her bp went to 60/40 (checked at home- gave fluids) then doc advised to get ecg (attached) done- it was normal as per him. As per holter readings (also attached pls chk), he advised ICD only. We were not aware she had a heart condition till the stroke (asyptomatic). Suring stroke treatent they performed 2DEcho - we found about Severe lv dysfunction and globalhypokenisis.
Three months doc performed angiogram to see why EF is low(32). I have attached angiogram report as well, which says MILD CAD.
Based on above could you please suggest if there is need for cardarone or ICD.
If there is a need, which one is the better option for patient (to not worsen patients condition further - with new syptoms and diseases)
Thanks in advance
By Stroke- I mean Brain stroke(not heart) , which I had earlier stated.
Only to find out the cause of low bp - holter was done. She never had an previous occurrence of low bp till now. So we were worried.
She was a patient of hypertension for a decade.
A few days back her bp went to 60/40 (checked at home- gave fluids) then doc advised to get ecg (attached) done- it was normal as per him. As per holter readings (also attached pls chk), he advised ICD only. We were not aware she had a heart condition till the stroke (asyptomatic). Suring stroke treatent they performed 2DEcho - we found about Severe lv dysfunction and globalhypokenisis.
Three months doc performed angiogram to see why EF is low(32). I have attached angiogram report as well, which says MILD CAD.
Based on above could you please suggest if there is need for cardarone or ICD.
If there is a need, which one is the better option for patient (to not worsen patients condition further - with new syptoms and diseases)
Thanks in advance
By Stroke- I mean Brain stroke(not heart) , which I had earlier stated.
Only to find out the cause of low bp - holter was done. She never had an previous occurrence of low bp till now. So we were worried.
She was a patient of hypertension for a decade.
Brief Answer:
ICD would be better option if EF is below 35%. Yes I did understand it
Detailed Answer:
I did understand that it is brain stroke.
If indicated ICD will be better than cardarone, but we need to access the candidacy for CRT D treatment in view of LV dysfunction. If no indication for CRT than ICD alone will suffice.
ICD would be better option if EF is below 35%. Yes I did understand it
Detailed Answer:
I did understand that it is brain stroke.
If indicated ICD will be better than cardarone, but we need to access the candidacy for CRT D treatment in view of LV dysfunction. If no indication for CRT than ICD alone will suffice.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor,
Thanks for your answer.
Could RF ablation/catheter ablation therapy help my mother in elimination of the PVCs/abnormal ectopics and also improve LVEF and help treat lv dysfunction. As my mom is suffering from numbness on right side of body, having CRTD and ICD related shocks will further detoriate her psychological behaviour and could lead to depression.
Thanks
Thanks for your answer.
Could RF ablation/catheter ablation therapy help my mother in elimination of the PVCs/abnormal ectopics and also improve LVEF and help treat lv dysfunction. As my mom is suffering from numbness on right side of body, having CRTD and ICD related shocks will further detoriate her psychological behaviour and could lead to depression.
Thanks
Brief Answer:
Could be an option
Detailed Answer:
It could be an option as long as consideration is present vpcs. If they are unifocal it can help. LV dysfunction is generally a cause rather than effect for ectopics. So whether it will improve LV is questionable. As I could understand ICD in her case will be being considered for primary prevention of VT/VF related sudden death in v/o her poor LV and in that case can not be replaced with RFA.
In small number of people repeated shocks can cause psychological issues such as depression but need to be managed as and when they arise.
Could be an option
Detailed Answer:
It could be an option as long as consideration is present vpcs. If they are unifocal it can help. LV dysfunction is generally a cause rather than effect for ectopics. So whether it will improve LV is questionable. As I could understand ICD in her case will be being considered for primary prevention of VT/VF related sudden death in v/o her poor LV and in that case can not be replaced with RFA.
In small number of people repeated shocks can cause psychological issues such as depression but need to be managed as and when they arise.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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