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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do my lab test reports indicate?

Answered by
Dr.
Dr. Salah Saad Shoman

Internal Medicine Specialist

Practicing since :2004

Answered : 2337 Questions

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Posted on Tue, 18 Apr 2017 in Medicines and Side Effects
Question: COPD. I have no records available to send you. MARCIA XXXXXXX KLAAS, 6 MARCH 1942 Colonoscopy (Branson, MO)     Date Performed:November 2014 GD/colonoscopy (Branson) Date Performed:October 2014 Cataract extraction and (Springfield, MO) insertion of intraocular lens     Date Performed: April 2014 & Feb 2017 Pacemaker Insertion     (Branson)     Date Performed: 2012 Cardiac Ablation (short of breath ever since, not before) (Little Rock, AR) Date Performed: 2011 Angiogram (Little Rock)     Date Performed: 2000 Esophagus reconstruction (Cincinnati, Ohio)     Date Performed: 1998 Oral surgery, palate Nissen     Date Performed: 1998 Fundoplication (Cincinnati)     Open reduction Internal fixation – right left 3 compound fractions – two plates & 13 screws (Little Rock)     Date Performed: XXXXXXX 1997 Cholecystectomy     Date Performed: 1993 Excision Tornwalt’s Bursa     Date Performed: 1974 http://www.ghorayeb.com/thornwaldtbursa (Denver) Laminectomy L3,4,5     (Denver)     Date Performed: 1974

I used to run & walk 2-3 miles a day on a track by the local XXXXXXX Center. I also had afib at the time which was OK. In 2011 Little Rock Heart Hospital did a cardiac abligation to burn the afib away. As soon as I was up and walking I couldn't breathe. I have seen pulmonologists etc. and they all say "No, it's AFib." My only symptom is I can't breath and walk. Walking up stairs takes me minutes as I have to stop every few steps. I was fine before the ablation.


doctor
Answered by Dr. Salah Saad Shoman 8 hours later
Brief Answer:
Pulmonary veins stenosis

Detailed Answer:
Dear sir, a common complication of the cardiac ablation is pulmonary vien stenosis. it occurs in around 5% of cases. pulmonary vine stenosis is usually presented with dysnea of the exceptional type. to confirm the diagnosis of PVS you need to undergo a ventilation perfusion test that examines the blood flow in the pulmonary veins. if the blood flow is decreased then the diagnosis of PVS is confirmed . another test is MRI scan to measure the dimensions of the pulmonary veins' orifices . if the orifice dimension is decreased in one of the pulmonary veins the diagnosis is confirmed.
once the diagnosis is confirmed an interventional procedure can be done to correct the stenosis using a stent
I hope I answered your question. if you do not have any other clarifications then please close the discussion.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Salah Saad Shoman 10 hours later
I am currently taking Pradaxa twice a day so don't believe there is any blockage.
doctor
Answered by Dr. Salah Saad Shoman 38 minutes later
Brief Answer:
Other mechanisms of PVS

Detailed Answer:
Dear Ms, pulmonary vein stenosis can occur by different mechanisms following the cardiac ablation. one of which is the formation of blood clots . this mechanism is prevented by Pradaxa. unfourtanetly Pradaxa does not prevent pulmonary vien stenosis by other mechanisms which include:
1) intense inflammation and collagen deposition following the ablation . this may compromise the lumen or even occlude it
2) extensive fibrosis in the perihilar pulmonary vien tissues following ablation leading to stenosis
this means that taking Pradaxa decreases the incidence of occurrence but doesn't prevent pulmonary vien stenosis .
I hope I answered your question. if you don't have any other clarifications then please close the discussion .
Above answer was peer-reviewed by : Dr. Prasad
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