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What causes breathlessness despite having sinus rhythm restoration?

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Posted on Wed, 25 May 2016
Question: today i had a cardio version done because of a-fib and because I could not breathe well when walking.I had serious breathless spells, lasting about 30 seconds, when I think I am oing to pass out. AFTER THAT SPELL SUBSIDES, I CAN GO ON AGAIN, BUT IT IS A REAL CHALLENGE. I WAS TOLD , AND I SAW IT ON THE MONITOR, THAT MY OXYGEN LEVELS WERE AT 99-100%. MY BLOOD PRESSURE IS REAL GOOD, AND MY HEART RYTHM SEEMS TO BE RESTORED, HOWEVER MY PROBLEM HAS NOT GOTTEN ONE BIT BETTER.WHAT DO YOU THINK IS THE MATTER?
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

Welcome on HCM!

I understand your concern and would like to explain that there are several reasons why your breathlessness episodes seem not to be completely gone after your sinus rhythm restoration.

First of all I would explain that atrial fibrillation impairs the normal atrial contribution on blood flow toward the left ventricle and as a consequence has adverse implications on pulmonary physiology and cardiac output.

That's why you have experienced that shortness of breath during atrial fibrillation presence.

But even after conversion of atrial fibrillation to normal sinus rhythm atrial muscle remains stunned for a few days and hence there is no immediate improvement in blood flow.

This is a reason why you don't see a prompt improvement.

Another reason is the primary health disorder that led to atrial fibrillation.

It may be a cardiomyopathy (with systolic and/or diastolic dysfunction).

In such case a cardiac ultrasound would be very informative in clarifying a responsible cardiac dysfunction in dyspnea occurrence.

Also other reasons like hypertension, thyroid dysfunction, a chronic or acute inflammation, etc. may have a concomitant contribution.

If you have any available medical tests reports, you may upload them here for a direct review and a second professional opinion.

I remain at your disposal whenever you need.

Feel free to ask me again in case of further uncertainties.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8596 Questions

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What causes breathlessness despite having sinus rhythm restoration?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome on HCM! I understand your concern and would like to explain that there are several reasons why your breathlessness episodes seem not to be completely gone after your sinus rhythm restoration. First of all I would explain that atrial fibrillation impairs the normal atrial contribution on blood flow toward the left ventricle and as a consequence has adverse implications on pulmonary physiology and cardiac output. That's why you have experienced that shortness of breath during atrial fibrillation presence. But even after conversion of atrial fibrillation to normal sinus rhythm atrial muscle remains stunned for a few days and hence there is no immediate improvement in blood flow. This is a reason why you don't see a prompt improvement. Another reason is the primary health disorder that led to atrial fibrillation. It may be a cardiomyopathy (with systolic and/or diastolic dysfunction). In such case a cardiac ultrasound would be very informative in clarifying a responsible cardiac dysfunction in dyspnea occurrence. Also other reasons like hypertension, thyroid dysfunction, a chronic or acute inflammation, etc. may have a concomitant contribution. If you have any available medical tests reports, you may upload them here for a direct review and a second professional opinion. I remain at your disposal whenever you need. Feel free to ask me again in case of further uncertainties. Kind regards, Dr. Iliri