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Suggest treatment for lightheadedness after stent placement

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Posted on Wed, 19 Oct 2016
Question: Hi
I am a white male 60 years old
I had two stents placed 7 weeks ago
One in my Lad 90% blocked
The other in R a 99% blocked
Within a week I was feeling real well

Like a fool I stopped at a bar, many people I knew were there
I ended up having 4 drinks
I got up
I was very light headed etc..

I been going to cardiac rehab
I take 75 mg of plavix
10 lisiniprol
And 10 Hytrin
My BP runs around 123/60
But I am more tired now than I was before the stents

I didn't have a heart attack
We got stents placed b4 we reached that status fortunately

Did I mess something up with the 4 alcoholic drinks

I have not had another since then

I told my cardiologist a week later
He just said it takes time
But that was 4 weeks ago
And we are no better,if not worse
doctor
Answered by Dr. Shuba Hariprasad (1 hour later)
Brief Answer:
Probably due to medications

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

I do not believe that your present symptoms are due to the alcohol.
I believe it is more likely due to the medications.
Hytrin can cause fatigue as side effect and may be felt more is by some people.

Would you please clarify a few things for me?

*are you a diabetic or have any other medical issues issues? Or take any other medications?
*do you smoke?
*have you lost or gained weight in the past 2 months?
*how has your routine activity and exercise level changed over the past 2 months
*any changes in bowel movements?

I recommend :
- a review with your cardiologist to see if the dosage or medication can be adjusted or changed and to check if the stents are working well.
-a physician consult to check for anemia, Thyroid problems and blood glucose levels.

Sometimes a small change can make a difference. It is possible that the alcohol potentiated the effects of the drugs that night with friends but I don't think it continues to do so.

Please review with your cardiologist to ensure all is well.
Please don't make any sudden movements or changes in position as it can exacerbate the light headedness /dizziness.

If your doctor advises you to continue medications, please do as these effects usually reduce in 2-3 months.

Hope this helps. Please let me know if there is anything else I can help you with.

I hope you feel better soon. Wish you good health
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Shuba Hariprasad (51 minutes later)
Hello

I am not diabetic nor do I smoke.
I've lost about 6 #'s since the stent placement
I been exercising and had been walking 4 miles. A day
Now I am fighting to get a half mile in

I only could do half my normal rehab today. I was wiped

I was doing so well 7 days after the stents
Now I am worse than b4
I have sleep apnea that I use a cpap for
I been on Hytrin for 5 years with no problems

I am speculating tbe plavix can be the culprit
And I know not to stop without the Drs orders as clotting is a death sentence

I called Dr early today left message with nurse
I have not heard back
I hate to go to Er
But if I don't hear by mid afternoon
I likely will
I think a echogram is in order
Before stents my echo results were 30
After the stents it was at 50 that was 7 weeks ago

I farm and I have a crop to Harvest
And all I can do is look at it.
I do take Librium periodically for anxiety

I took one 25 mg last night
But Librium doesn't make me tired

With my extreme fatigue I am at the point that driving a car or talking is exhausting
Unbelievable
Am I right to go to ER if Dr doesn't return call by mid day
It is 12:30 now and he closes at 5:00

Cardiologist never followed up
Nor did you

I know there is no time table for either of you
doctor
Answered by Dr. Shuba Hariprasad (9 hours later)
Brief Answer:
Yes, please visit the ER right away

Detailed Answer:
Hello Sir,
Thank you for the follow up.

I am truly sorry that I couldn't reply earlier.
We did have a schedule to answer to any follows ups before 20 hours of posting and as soon as possible.

To address your concerns, it seems that your symptoms are severe. Based on your symptoms I would like to primarily rule out Stent failure

I recommend :
-an ER visit right away.
-an echocardiogram and electrocardiogram to check heart function and activity
- chest x-ray to look for fluid in the lungs
-blood tests (complete blood count, cardiac enzymes)
-a repeat angiography to check for Stent malfunction or blockage
-an arterial blood gas analysis to check for increased carbon dioxide levels
-a repeat sleep study to check any changes in Cpap device pressure requirements.

Plavix may lead to internal bleeding over the long run which can be detected by change in the color of stools or a low hemoglobin level.
I urge you to seek medical attention right away.

Hope this helps. Please let me know if there is anything else I can help you with.
Once again, I'm sorry for not being able to reply sooner.
Hope you feel better.

Wish you good health.
Regards,
Dr. Shuba Hariprasad


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Shuba Hariprasad (19 hours later)
I woke up this morning
I was tired
I decided not to fight it and just rest
By noon I felt fair
I drove 5 miles to the farm
I was zapped

The Er dr gave me imdur 30 mg to take last night
I haven't taken it yet as a common side effect is a headache
I maybe should take it
But I am sick of being sick
doctor
Answered by Dr. Shuba Hariprasad (6 hours later)
Brief Answer:
Please take the medication

Detailed Answer:
Hello Sir,
Thank you for the follow up.

*how was your blood pressure and heart rate when you visited the ER?
*did they do an echo wandering electrocardiogram?
*any blood work?
*did you have any chest discomfort /pain? Or breathing difficulty?
*did they tell you what was wrong?


Yes one of the common side effects of imdur is headache. The ER doctor must have prescribed it for suspected angina. Please take your medication as prescribed.
I urge you to speak with your cardiologist as soon as possible.

If you still feel weak, or develop giddiness, breathing difficulty or chest pain, unexplained sweating, please visit the ER again right away. Please don't drive.

Hope this helps. I sincerely hope you recover soon.

Kind regards,
Dr. Shuba Hariprasad


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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Suggest treatment for lightheadedness after stent placement

Brief Answer: Probably due to medications Detailed Answer: Hello, Thank you for your query. I'm Dr. Shuba Hariprasad and will be answering your query today. I do not believe that your present symptoms are due to the alcohol. I believe it is more likely due to the medications. Hytrin can cause fatigue as side effect and may be felt more is by some people. Would you please clarify a few things for me? *are you a diabetic or have any other medical issues issues? Or take any other medications? *do you smoke? *have you lost or gained weight in the past 2 months? *how has your routine activity and exercise level changed over the past 2 months *any changes in bowel movements? I recommend : - a review with your cardiologist to see if the dosage or medication can be adjusted or changed and to check if the stents are working well. -a physician consult to check for anemia, Thyroid problems and blood glucose levels. Sometimes a small change can make a difference. It is possible that the alcohol potentiated the effects of the drugs that night with friends but I don't think it continues to do so. Please review with your cardiologist to ensure all is well. Please don't make any sudden movements or changes in position as it can exacerbate the light headedness /dizziness. If your doctor advises you to continue medications, please do as these effects usually reduce in 2-3 months. Hope this helps. Please let me know if there is anything else I can help you with. I hope you feel better soon. Wish you good health Regards, Dr. Shuba Hariprasad