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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes pressure in eyes, fainting and loss of coordination while having stroke?

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7017 Questions

default
Posted on Tue, 7 Jun 2016 in Valvular Heart Disease
Question: Me

Male, aged 65, fit and active

Medical History (Major Recent Events)

Heart Surgery 2010 - Replace aortic valce, valve root and ascending aorta
Endocarditis 2013 ==> kidney function damaged, strokes (fully recovered (?ha)) and ???

Currently very ashmatic (dust)

During 2015-2016 I experienced several incidents where
I sensed pressure in the eyes,
then
felt faint,
then
lost hand-eye co-ordination (eg unable to put toothpast on toothbrush) (April 2016)

Duraton of incident: 2-3 mins XXXXXXX

Frequency - maybe quarterly

Any thoughts Doctors?

XXXX
doctor
Answered by Dr. Ilir Sharka 50 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that these episodes could be related to different causes:

1. Transitory ischemic events (more probable explanation). Your past medical history for stroke is a risk factor for possible TIA (transitory ischemic events).
2. Partial epileptic seizures, although the symptomatology is not typical of epilepsy seizures.

What drugs are you taking actually? Are you taking any anticoagulation or antiplatelet agents ?

Transitory ischemic events can be explained by hypoperfusion of certain regions of the brain during short periods. They could be related to heart embolism or to vessel atherosclerosis.

I would recommend consulting with your attending physician for a careful physical exam and some tests :

- a resting ECG and cardiac ultrasound to examine your heart and function
- Doppler ultrasound of the cervical vessels to examine the blood flow to the brain and investigate for possible vessel narrowing or atherosclerotic plaques
- an ambulatory 24-48 hours ECG monitoring would be necessary to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia
- some blood lab tests (complete blood count, blood lipid profile, fasting glucose, kidney and liver function tests, PCR, sedimentation rate for inflammation).

A brain MRI coupled with MRA (for the examination of intracranial vessels) would help examine your brain and exclude possible ischemic events.

You should discuss with your doctor on the above issues.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka 23 hours later
Thanks doctor, very helpful, and what I had feared.

At present I am taking:
Cephalexin (1000 mg 2 x per day) (prophylactic to prevent repeat endocarditis)
Allopurinol (100 mg/day and have been advised to increase to 200 mg/day) (gout)
Valdoxan (25 mg/day) (anti-depressant)
Rabeprazole sodium (20 mg/day) (reflux - problem since heart op in 2010)
Rivaroxoban (15 mg/day) (heart)
Cordilox (180 mg/day) (ditto)

cialis (10-40 mg when necessary,depending on my crankiness)

All of these are prescribed, and I am not sure that all are compatible. I would appreciate your advice on this.

Also taking multivitamins, fish oil capsules, vitamins C and E, zinc tablets. These on various advice (mostly suspect) to maintain a lifestyle that already has passed

XXXX
doctor
Answered by Dr. Ilir Sharka 8 hours later
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

I carefully reviewed all your therapy and would explain that you are on anticoagulation (Rivaroxaban), which is the treatment of choice for the prevention of possible TIA.

Unfortunately the science has not produced any medicine which can protect you 100%. But I can assure that this is one of the best drugs for this purpose.

I also would explain that no one of the other drugs your are taking interacts with rivaroxabane by lowering its effects.

Otherwise, Cordilox and valdoxan can slightly increase its plasma levels, by increasing the risk of possible bleeding.

I would recommend you to be careful to possible bleeding signs. In such case you should go to the ER for some tests.

I would not change anything in your actual therapy. I would encourage you to continue with your rich diet and perform a lot of physical activity.

Hope you will find this answer helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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