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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Is Bradycardia Treated?

My 83 yr. old husband is 5 yrs status post a CABGx5 following an acute MI. He had a pace maker placed 16 months prior to the MI for a long term but worsening bradycardia. The pacer has kept his pulse from going below 60 and had no cap on a rapid rate. Now a new development, A Fib, and his pacer has been set at 80; never any faster or slower, even after a good exercising walk involving some inclines which will raise my normal pulse to around 100. He will be slightly out of breath, for a brief recovery time but never an increase in his pulse. Since the A Fib he has been extremely fatigued - all the time. He goes to bed exhausted and wakes up just as tired. He has an app t. with his cardiologist but what should we be inquiring about and requesting as far as treatment? He is on Coreg, Dig, Lasix, KCl, ASA 81 mg. and his INR is easily controlled with Coumadin. Liptor was DC d recently due to some severe muscle pain in his lower extremities. He does not have sleep apnea but snores a good bit. He is in otherwise good health, has always been very athletic, never overweight, plays golf 3x a week, but is becoming more than distressed and perhaps somewhat depressed. Have you any comments or suggestions? Thank you very much. Cassandra
Tue, 30 Sep 2014
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Psychiatrist 's  Response
Hi welcome to HCM.
The symptoms of breathlessness in your husband's case might be related to the onset of congestive cardiac failure secondary to long standing pathologies of the heart like ch atrial fibrillation and post CABGx5 due to acute MI.This is a part of the overall gross reduction in the pumping efficiency of heart due to ventricular remodelling.Currently he is on standard regimin of drugs.I advice you to get him a 2 dimensional echo of the heart for assessment of his cardiac reserve.Consult your cardiologist for further help.
Thank you
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How Is Bradycardia Treated?

Hi welcome to HCM. The symptoms of breathlessness in your husband s case might be related to the onset of congestive cardiac failure secondary to long standing pathologies of the heart like ch atrial fibrillation and post CABGx5 due to acute MI.This is a part of the overall gross reduction in the pumping efficiency of heart due to ventricular remodelling.Currently he is on standard regimin of drugs.I advice you to get him a 2 dimensional echo of the heart for assessment of his cardiac reserve.Consult your cardiologist for further help. Thank you