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What Causes Swelling In The Feet And Hands And Shortness Of Breath?

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Posted on Thu, 17 Nov 2016
Question: Hi, I recently had swollen feet and hands...not consistent...usually happens when I am standing or need to urinate. But prior to that...4-6 months ago I've had a stroke like episode... And that was due to shortness of breath... And the shortness of breath has gradually worsen since then... The doctors couldn't pin point exactly what was wrong with me... I was discharged with the knowledge from the doctors that I may have fluid around my heart which is causing my shortness of breath... I went home with 4 prescribed medications.. Which are coversyl 2mg, furosemide 20mg, carvedilol 3. 125mg & Teva-spironolactone. I was given a month worth to take... But those pills made me feel ok at times and worse most of the times I was taking them. I decided to gradually lean off those pill and started taking Coq10 and fish oil supplements.... Which it took getting use to... Now whatever symptoms I've had I still have... Shortness of breath often occurs while I do household activity and walking... I still have my cough I had then.... Runny nose, itchy throat... Swollen hands and feet numbness of my tongue and around my mouth along with shortness of breath I experienced just this week... And one thing I discovered lately that I didn't notice before is some sort of infection in my right ear... I plan to see my doctor...as soon as I have arranged a transportation means... Cause I wouldn't want to commute on my own... But until then can any doctor tell me what I have? And what I can do till I see my doctor?
doctor
Answered by Dr. Ilir Sharka (26 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that your symptoms seem to be related to increase fluid retention.

Your symptoms (shortness of breath, legs and hand swelling, chronic fatigue) are very suggestive of decompensated heart failure.

From the other hand the infection in your ear, runny nose, itchy throat may indicate an infection or an inflammatory state, which may have affected also your heart.

Coming to this point, I would recommend starting again lasix and Teva-spironolactone.

Lasix is a diuretic, which helps prevent and treat fluid retention. The previous dose that you have been using (20mg) is a really low dose. I would recommend increasing the daily dose to at least 60mg divided in two doses, in order to have a more steady and prolonged effect during the day.

Spironolactone is another diuretic, which helps prevent potassium losses. It is recommended to take it with lasix, in order to prevent low potassium levels.

What are your actual blood pressure values?

If your blood pressure values are at least 120/80mmHg on average, I would also recommend to continue taking Corversyl 2mg and Carvedilol 3.125mg as they help in providing more favorable cardiac loading conditions (may improve the cardiac muscle perfomance), thus improving your situation.

What is your body temperature? Do you have fevers?

I would recommend taking acetaminophen (Tylenol) if you have fever.

Another advice, I would give to you is to measure your daily body weight and urine output, in order to provide a more comprehensive review of lasix effect.

Try to pay attention to the fact of not drinking more fluids (water, juices) than you eliminate (besides urine, you should know that around 1000ml fluids are eliminated by respiration and sweating).

If your leg swelling and body weight begin to decrease, it would indicate that we are in the right way of addressing your actual condition. In such way keep following the above recommendations until you contact with your doctor.

But otherwise, if your symptoms and signs continue to aggravate you should immediately ask medical help to the nearest ER service for a physical exam and some tests:

- a resting ECG and cardiac ultrasound to examine your heart function and structure
- a chest X ray study
- blood electrolytes
- complete blood count for anemia
- kidney and liver function tests
- NT pro BNP levels.

Hope you will find this answer helpful!

Feel free to ask me again whenever you need!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (4 hours later)
Are there any natural supplements that I can take instead of those pills...? I've been taking coq10 60mg and fish oil 700mg on a daily basis....and seems to be quite beneficial.. I have no troubles visiting the washroom as often as after every meal.... Unlike, with those pills, I often feel constipated... And I didn't have my menstrual period during & after taking those prescription...while prior to taking them I had my period on a regular monthly basis... Just recently, I had my period and that's 4 months after stopping with those pills and 3 months of daily intake of supplements... I was also thinking of adding Hawthorn with my supplements as well centrum for women... What are your opinions?
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Regarding your concern, I would explain that spironolactone and coversyl can cause irregularities or a dysfunction in the menstrual cycle.

Coming to this point, I would recommend avoiding these drugs.

But Lasix is not related to such adverse effects. I would advise taking it as above mentioned in a 60mg daily dose.

Regarding supplements, I agree with your decision on starting coenzyme Q10 daily.

Hawthorn supplements are also helpful coupled with multivitamins (like centrum) in your clinical situation. Hawthorn is really recommended to increase microcirculation and the heart muscle performance. Potassium supplements or food reach in potassium is also helpful in avoiding possible low potassium levels (which can be caused by lasix intake).

Hope you will find this answer helpful!

I remain at your disposal for further questions, whenever you need!

Best wishes,

Dr. Iliri
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. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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What Causes Swelling In The Feet And Hands And Shortness Of Breath?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would explain that your symptoms seem to be related to increase fluid retention. Your symptoms (shortness of breath, legs and hand swelling, chronic fatigue) are very suggestive of decompensated heart failure. From the other hand the infection in your ear, runny nose, itchy throat may indicate an infection or an inflammatory state, which may have affected also your heart. Coming to this point, I would recommend starting again lasix and Teva-spironolactone. Lasix is a diuretic, which helps prevent and treat fluid retention. The previous dose that you have been using (20mg) is a really low dose. I would recommend increasing the daily dose to at least 60mg divided in two doses, in order to have a more steady and prolonged effect during the day. Spironolactone is another diuretic, which helps prevent potassium losses. It is recommended to take it with lasix, in order to prevent low potassium levels. What are your actual blood pressure values? If your blood pressure values are at least 120/80mmHg on average, I would also recommend to continue taking Corversyl 2mg and Carvedilol 3.125mg as they help in providing more favorable cardiac loading conditions (may improve the cardiac muscle perfomance), thus improving your situation. What is your body temperature? Do you have fevers? I would recommend taking acetaminophen (Tylenol) if you have fever. Another advice, I would give to you is to measure your daily body weight and urine output, in order to provide a more comprehensive review of lasix effect. Try to pay attention to the fact of not drinking more fluids (water, juices) than you eliminate (besides urine, you should know that around 1000ml fluids are eliminated by respiration and sweating). If your leg swelling and body weight begin to decrease, it would indicate that we are in the right way of addressing your actual condition. In such way keep following the above recommendations until you contact with your doctor. But otherwise, if your symptoms and signs continue to aggravate you should immediately ask medical help to the nearest ER service for a physical exam and some tests: - a resting ECG and cardiac ultrasound to examine your heart function and structure - a chest X ray study - blood electrolytes - complete blood count for anemia - kidney and liver function tests - NT pro BNP levels. Hope you will find this answer helpful! Feel free to ask me again whenever you need! Kind regards, Dr. Iliri