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Open heart surgery done. Feeling cold, fever and blurred vision. Started smoking. Any risks?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
my husband had open heart surgery 10 yrs. ago.. still smokes ..has had 2 T I A 's . Stays cold all the time..Body temp average 97.His age is 65 yrs. old.. Takes no meds..Won't.. Last week.. T I A ? Blurred vision last about 30 min. BP 185/102 Hr 56
Posted Mon, 5 Nov 2012 in Hypertension and Heart Disease
Answered by Dr. Mayank Bhargava 49 minutes later
Thanks for posting your query.
The blurring of vision could represent a Transient ischemic attack. Given his history, he is definitely predisposed to such a condition.
The TIA could either be due to a local obstructive process where a thrombus forms at the site itself or we could also have a clot travelling from the heart.
The best way here would be to get a diffusion weighted MRI of the brain done. We would also need to run some other tests like a blood sugar, lipid profile (to rule out lipid disorders, deranged by smoking and common with hypertension), 2 D Echo (to rule out thrombus inside the heart chambers), color doppler study of both carotid arteries (to rule out thrombus formation with detection of carotid artery intima media thickness).
I think it would be best if we start treatment. No medication is definitely not an option here.
Recurrent brain parenchymal injury may cause lacunar infarct with permanent damage of brain tissue with loss of memory, decreased thinking ability, slow response as a consequences.
He should take antiplatelets, strict control of blood pressure, statins (if lipid profile is deranged) on written prescriptions.
Cold extremities may not be due to heart disease or TIA as your husband has high blood pressure. There may also be possibilities of peripheral artery disease, as he smokes. You should also go for color doppler study of both lower limb (arterial & Venous) along with thorough peripheral pulse check up.
Hope that helps
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
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