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Suggest treatment for swelling through out body in a heart patient

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Posted on Wed, 25 May 2016
Question: My father - in -law... operated and put pacemaker..due to heart failure... then found he is suffering from copd, lrt_infection, edema, cor pulmonale. .. at now. He is having seviour sweeling on his leg and through out his body also wheezing... pls tell us what to do?? It is life threatening? ??
doctor
Answered by Dr. Shuba Hariprasad (2 hours later)
Brief Answer:
Severe cor pulmonale is life threatening, Urgent care needed

Detailed Answer:
Hello XXXXX,
I am Dr.Shuba Hariprasad and will try to address your concern adequately.

Would you please clarify a few things for me?
1) Does he have a history of heart disease, diabetes, hypertension, high cholesterol levels?
2) was he a smoker or an alcoholic?
3) Has this swelling appeared after his surgery (pace maker insertion) or was it present before? If it was present before, has it reduced?

Cor pulmonale is the presence of heart failure secondary (due to)to lung problems. The right side of the heart pumps deoxygenated blood into the lungs. this blood then returns from the lungs to the left side of the heart and is pumped through the rest of the body.

The blood from the body drains then into the right heart and the cycle repeats.
When the lung is damaged by chronic disease, it causes increased pressure in the lungs which inturn causes pooling of blood in the right side of the heart. This then prevent blood from the body to empty completely into it which leads to pooling of blood in the lower body. this leads to liver & kidney damage and swelling throughout the body.

This is the most severe complication and has a poor prognosis ( I'm afraid to say that chances of 'full' recovery is less).

Based on the clinical findings and the onset and duration of symptoms, treatment can be aimed at making him comfortable to breathe.

I urge you seek medical help right away as this could go from bad to worse.

Placement of pacemaker can help by regularizing the heart beat and can ease his symptoms to an extent ( this corrects a heart beat that is too slow or irregular) but does not treat cor-pulmonale.

Talk to his doctor as to what to expect, his chances of survival and leading a life with basic functions. You will need to also discuss of life prolonging measures such as ventilation and intensive care.

In the meanwhile try to give him Nebulization with SALBUTAMOL (if you have nebulizer at home) along with Oxygen via Nasal Prongs @ 2L/min for temporary relief..

Please don't panic, take him to the ER/doctor, ask questions till you get satisfactory answers and make and informed decision.

Hope this helps and I sincerely hope your father -in-law feels better.

Please get back to us if you have further queries.
Wish you all good health
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Shuba Hariprasad (10 hours later)
He is not smoker, no diebatic, no hypertension., before and after surgery his swelling is still increase... not improvement.. feel very tired and less breathing... can't event take bath alone...
doctor
Answered by Dr. Shuba Hariprasad (8 hours later)
Brief Answer:
Severe corpulmonale with congestive heart failure

Detailed Answer:
Hello Ms. XXXXXXX

His conditions warrants a hospital visit. It seems that he is in congestive heart failure and associated complications (including, but not only, pulmonary edema).
What was his course in the hospital like (his vital parameters-blood pressure, pulse, saturation). If you have any reports (blood, echocardiogram, xray), discharge summary with course in hospital, his old and current prescription, I would like to see them.
If an individual presented to me with these issues, I would admit him and do an ABG(arterial blood gas analysis), check his kidney and heart function, restrict fluids if necessary. He may also need breathing support by positive pressure ventilation.

Please get back to me with the available details.
Hope I could be of help. In case, you decide that you don't require further clarification, pls close the conversation and rate my answer.
Wish you all good health.

Above answer was peer-reviewed by : Dr. Yogesh D
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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 swelling through out body in a heart patient

Brief Answer: Severe cor pulmonale is life threatening, Urgent care needed Detailed Answer: Hello XXXXX, I am Dr.Shuba Hariprasad and will try to address your concern adequately. Would you please clarify a few things for me? 1) Does he have a history of heart disease, diabetes, hypertension, high cholesterol levels? 2) was he a smoker or an alcoholic? 3) Has this swelling appeared after his surgery (pace maker insertion) or was it present before? If it was present before, has it reduced? Cor pulmonale is the presence of heart failure secondary (due to)to lung problems. The right side of the heart pumps deoxygenated blood into the lungs. this blood then returns from the lungs to the left side of the heart and is pumped through the rest of the body. The blood from the body drains then into the right heart and the cycle repeats. When the lung is damaged by chronic disease, it causes increased pressure in the lungs which inturn causes pooling of blood in the right side of the heart. This then prevent blood from the body to empty completely into it which leads to pooling of blood in the lower body. this leads to liver & kidney damage and swelling throughout the body. This is the most severe complication and has a poor prognosis ( I'm afraid to say that chances of 'full' recovery is less). Based on the clinical findings and the onset and duration of symptoms, treatment can be aimed at making him comfortable to breathe. I urge you seek medical help right away as this could go from bad to worse. Placement of pacemaker can help by regularizing the heart beat and can ease his symptoms to an extent ( this corrects a heart beat that is too slow or irregular) but does not treat cor-pulmonale. Talk to his doctor as to what to expect, his chances of survival and leading a life with basic functions. You will need to also discuss of life prolonging measures such as ventilation and intensive care. In the meanwhile try to give him Nebulization with SALBUTAMOL (if you have nebulizer at home) along with Oxygen via Nasal Prongs @ 2L/min for temporary relief.. Please don't panic, take him to the ER/doctor, ask questions till you get satisfactory answers and make and informed decision. Hope this helps and I sincerely hope your father -in-law feels better. Please get back to us if you have further queries. Wish you all good health