Hi,I am Dr. Joan F. Tryzelaar (Cardiac Surgeon). I will be looking into your question and guiding you through the process. Please write your question below.
Should A Patient Having Two Artificial Heart Valves And A Syncopal Episode With A 7 Second Heart Stop With No Loss Of Consciousness Be Transferred To A Center Which Can Do Transesophogeal Echo And Pacemaker Insertion Asap?
Brother age 65 lives outside of Toronto and has 2artificial heart valves (staph infection damaged valves over 15 years ago) and was admitted to ccicu 3days ago following a syncopal episode ---has had only 3 "events" since admission most recent 7 second stop of heart with no loss of consciousness. They are trying to get him transferred to a regional cardiac centre for a transesophogeal echo and insertion of a pacemaker. They say they will do an emergency placement if episodes continue and warrant intervention. He didn't say but I assume there's no bed available at this other hospital, also huge "flu" in most centers. No growth on cultures, no elevated WBC, no fever----on low dose Heparin per IV drip. They don't feel it is a clot problem----did regular echo on admission and did clot buster prophylaxis. My question ---should we push to get him transferred to a centre that can do the procedures ASAP? Canadian system obviously different than ours. BTW I'm an RN---work in Neonatal ICU so have been giving myself a quick update on adult cardiac care! Ev
Dear Ma'm/ Sir Thanks for writing to us. Definitely, repeated syncopal attacks with stopping of heart for seven minutes need urgent intervention. If there is no reversible cause found on evaluation, Pacemaker is usually installed urgently in such cases in our practice. Transesophageal ECHO will see around Aortic prosthetic valve particularly. As the abscess around this valve may result in complete heart block and syncope. hope this helps Sincerely Sukhvinder
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Should A Patient Having Two Artificial Heart Valves And A Syncopal Episode With A 7 Second Heart Stop With No Loss Of Consciousness Be Transferred To A Center Which Can Do Transesophogeal Echo And Pacemaker Insertion Asap?
Dear Ma m/ Sir Thanks for writing to us. Definitely, repeated syncopal attacks with stopping of heart for seven minutes need urgent intervention. If there is no reversible cause found on evaluation, Pacemaker is usually installed urgently in such cases in our practice. Transesophageal ECHO will see around Aortic prosthetic valve particularly. As the abscess around this valve may result in complete heart block and syncope. hope this helps Sincerely Sukhvinder