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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest remedies for sleeping difficulty post angioplasty

Answered by
Dr.
Dr. Arnab Banerjee

Critical Care Specialist

Practicing since :2012

Answered : 1304 Questions

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Posted on Sat, 3 Sep 2016 in Hypertension and Heart Disease
Question: Hello,
My father did the angioplasty with scents last one month. Since then he is facing the problem of not getting proper sleep at night. The oxygen level comes down to 89 for few seconds. This happens when is lying down. But while he is standing or sitting, it doesn't happen. After walking a few minutes he feels exhausted. Also some acidity problem persists. We even did the echo.but it's ok.please suggest what to do.....
doctor
Answered by Dr. Arnab Banerjee 7 hours later
Brief Answer:
several possibilities can be there..

Detailed Answer:
Hello XXXXXXX Welcome to HCM,

I've gone through your query and understand your concern for your father..

What you've described, can indicate several possibilities:

First of all Echo before angioplasty and after angioplasty must be compared thoroughly(by his Cardiologist preferably) even if it shows normal range values..

Secondly, a Chest X-Ray is a must to look for any underlying Effusion(pleural vs pericardiac vs any other etiology)..

Thirdly, A Doppler guided stent patency and position study should be carried out by the concerned Cardiologist(who has done the angioplasty), please report all this present complaints in details to him so that necessary measures can be carried out without further delay..

The inadequacy of sleep is a very common problem in this group of patients, I'd suggest you not to let him lie down straight , instead let the head end of the bed a bit elevated(if your having that functionality) otherwise putting one/two extra pillow will help..

Yes, even in normal healthy individual there's a transient drop in blood oximetry during sleep, and in the post-angioplasty patient, body undergoes several changes, and due to them, change of posture from sitting/standing to lying down causes changes in pattern of blood flow which causes that sudden drop of oxygen saturation for a few seconds..

You should also look for any signs of snoring during sleep, if that happens, try to make him lie down in lateral position and not supine(face upwards), here also putting that extra pillow to keep head end elevated will help..

Please make sure every change of posture should take some time, don't let him lie down abruptly from sitting/standing and same goes when he gets up from the bed also, make sure that he first gets up , sit down in bed for 10 minutes then stand up and start walking, these are routine precautionary methods you need to follow immediately after angioplasty..

There may be a need to optimize the doses of his cardiac medication based on the current vital parameters(specially if he's on any beta blockers and/ diuretics), which'll be decided by his cardiologist after complete evaluation..

I'd not suggest giving any sedatives to him for now, until those other causes are ruled out..

For acidity problem, put him on Cap Pantoprazole 40 mg Once Daily 15-20 min before breakfast for next 15 days. make sure he eats simple home cooked less oily/spicy foods..

I've tried to make it as simple as possible for you to understand, please get back to me if your having any further doubts/queries..

Also schedule the Cardiologist's appointment and let me know how he stays in the due course..

Take Care
Kind Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Arnab Banerjee 14 hours later
medicines taking right now.
1. brilinta 90 mg twice.
2. ecosprin 75mg
3. rejunex
4. flavedon mr 35mg
5. rojavel 20mg
please suggest which dose to reduce. in case we can come and consult you also.
doctor
Answered by Dr. Arnab Banerjee 1 hour later
Brief Answer:
follow as already advised ..

Detailed Answer:
Dear XXXXXXX Welcome back,

Thanks for following up,

His list of medications are just fine, no dose reduction is necessary..

Just add the Pantoprazole as I've already advised previously..

Most importantly, follow all those advises including the cardiologist's check up and those investigations for any further evaluation.. I can see your contacting from XXXXXXX XXXXXXX there's a lot of good private multispeciality hospitals from where you can easily get them done..

Alternatively, you can take care him to XXXXXXX hospitals in XXXXXXX also (you must be knowing).. I'm practising in XXXXXXX dear, no need to come so far for this, as you can easily get them done at your place only..

Still, with all those being said, I'd suggest you to contact the concerned Cardiologist who'd performed the angioplasty and explain him/her the present condition along with those complaints and let him/her examine your father and get those necessary investigations done(as I've already listed), simply because he/she is the best one to intervene in the first place..(i hope you'll understand what i'm trying to explain you)..

Let me know if you'r having any further concern..I'll be glad to clarify..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Arnab Banerjee 2 hours later
also sir, he is allergic to sulphur. I am not able to contact my doctor. Please suggest what shall I do.
doctor
Answered by Dr. Arnab Banerjee 27 minutes later
Brief Answer:
good point, but sulfur allergy is not related to any of this, unless stent itself contained any sulfur component, which is highly unlikely

Detailed Answer:
Welcome back XXXXXXX

Don't worry, sulfur allergy has nothing to do with it, unless the stents contain any sulfur derivative, which is highly unlikely, so please stop worrying..

Take your time and relax, and you'll definitely be able to contact your Doctor, just don't stress yourself out..

Do not panic, just try to contact his clinic/hospital's address and contact the OPD dept./ concerned Dept. so that you can get the whereabouts of him..don't worry, and if you still feel it's at all really serious, you can always take him to your nearest ER/hospital for a immediate check-up (but as from your description , I don't think it's that serious, but yes as I can't examine him physically, so I can't give you 100% assurance on that front)

Please don't panic, and do the needful.. I still don't think it's that serious, so if can get hold of your doctor after some time also, it's fine..just be vigilant in the meanwhile (and if you still feel it's at all really serious, you can always take him to your nearest ER/hospital for a immediate check-up, but again I'm telling you it's not that serious as per all those description, so stop worrying so much) ..

Take Care
Kind Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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