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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Apnea In Case Of Heart Failure

79 year old father with diagnosis today at yearly check up at cardio specialist of 1. diastolic heart failure (chronic), 2. atrial fib, 3. Benign hypertension, 4. Hypercholesterolmia, 5. Cardiomyopathy, other primary, 6. Dyspnea, 7. Low blood pressure. Previous year official diagnosis was only atrial fib, dyspnea, slight hypertension, with possible CHF, little or no high cholesterol readings, not diabetic. Was told he had a heart murmur when young, never has eaten much salt, however drank up to a liter of diet soda daily up until six months ago, never smoked. Has always been overweight, current weight is 284, which is somewhat less than last year. Sleeps with breathing machine due to apnea, cannot walk 25 feet without shortness of breath. Occasionally has legs fall asleep, especially when driving. Over he past few weeks left hand has had tingling and sensation of falling asleep. Meds prescribed over the last year or so are amlodipine 10 mg 1xdaily, hydrochlorothiazide 25 mg 1x, lotensin 40 mg 1x, meloxicam 15 mg 1x, and pradaxa 75 mg 2x daily. Today they scheduled his annual 2Dwith CFD Echocardiogram for mid October. On the hour drive back from the appointment, his hand fell asleep again with the tingling sensation. The doctor seems unconcerned, but I feel that today s BP readings of 82/38 should be of concern. I had always thought that diastolic readings that low were dangerous, and also reflected low oxygen levels, although I can see why they need to be kept somewhat low for his condition. I am questioning the medication program as to whether it may be more than he needs. What critical symptoms do I need to watch for?
Tue, 14 Jul 2015
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Pulmonologist 's  Response
thanks for your question
i understand your concern
actually if current blood pressure is as u wrote around 85/40 is surely a matter of concern.
you should visit the treating physician and re check and re organise all the medications as he is having hypotension but before that serial blood pressure monitoring should be done for atleast 1-2 days 6 hrly
continue with the sleep apnoea machine ( either bipap or cpap)
thanks
feel free to ask more questions
may god bless your family with good health
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Suggest Treatment For Apnea In Case Of Heart Failure

thanks for your question i understand your concern actually if current blood pressure is as u wrote around 85/40 is surely a matter of concern. you should visit the treating physician and re check and re organise all the medications as he is having hypotension but before that serial blood pressure monitoring should be done for atleast 1-2 days 6 hrly continue with the sleep apnoea machine ( either bipap or cpap) thanks feel free to ask more questions may god bless your family with good health