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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Strokes, Partial Vision Loss. Had Aortic Dissection. Taking Clonidine And Lisinopril. Can I Carry On With Normal Activities?

For the past month when I wake up I see green for a couple of seconds. I have to close and open my eyes three times for it to go away. I can focus fine. It's like looking through green glass.

Eight months ago I had an aortic dissection which caused four strokes. Miraculously I've made a complete recovery in eight months except for partial vision loss in the bottom right quadrant or my right eye. I was cleared by my cardiologist after five months to resume normal activities with some restrictions (weight lifting, long distance running). My neurologist, ophthalmologist and neural ophthalmologist cleared me a month ago just before this situation occurred. I saw my PCP physician a couple of days ago. He didn't have any answers other than contact the neural ophthalmologist which I haven't done yet.

I'm taking lisinopril, clonidine, metoprolol for blood pressure and simvastatin and niaspan as a preventative measure for one year from my surgery. I also take vitamin B, vitamin D, folic acid and a 325mg aspirin daily. My PCP said I wasn't having side effects from medicine.

I'm in good physical condition, 6', 175. All my vitals were normal at the doctor's office this week.
Fri, 8 Nov 2013
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Pediatrician, Cardiology,  's  Response
Hi, I have gone through your query and understand your concerns.

At first you should know the aortic dissection is a serious condition and re-dissection or extension of the dissection may occur. However, it is unlikely in patients who maintain excellent blood pressure control and limit physical activity. You should follow up with your cardiologist and with serial imaging frequently during the first 2 years after a dissection, and every 1-2 year afterwards.

About your medicines, Lisinopril (ACE inhibitor), clonidine (a very strong anti hypertensive) and metoprolol (a beta blocker) all work to reduce blood pressure. Beta-blockers also work if you have rhythm problems with your heart. If your blood pressure is controlled, you may ask your doctor to review your medications and to adjust or stop clonidine.

Even you have a normal body mass index (BMI=23.7, 175 pounds /6 feet), Simcor (Niaspan and simvastatin) is a cholesterol-lowering medication, which holds promise in lowering cholesterol levels even more, thus further helping prevent heart disease. If you have high cholesterol levels and tolerate flushing, hot flashes from Niaspan, you can continue to take the simcor.

With excellent blood pressure control and conscious limits to physical activity, you can continue to lead long, full lives after a dissection. This would include returning to most jobs, but no work in physically demanding jobs such as construction, ect…

Also while you are able to physically return to your previous physical conditioning and feel able to engage in strenuous activities such as sports, you should exercise caution. Strenuous activities such as sports will increase the stress on the aortic wall, increasing the risk for enlargement of the weakened aorta or even re-dissection. Mild exercise is usually considered OK.

I would agree that alcohol in moderation is permitted and usually no more than 1 alcoholic beverage. Among other things, alcohol can affect or interact with some of the medications that you have suffered aortic dissections receive.

Wish you good health.
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Strokes, Partial Vision Loss. Had Aortic Dissection. Taking Clonidine And Lisinopril. Can I Carry On With Normal Activities?

Hi, I have gone through your query and understand your concerns. At first you should know the aortic dissection is a serious condition and re-dissection or extension of the dissection may occur. However, it is unlikely in patients who maintain excellent blood pressure control and limit physical activity. You should follow up with your cardiologist and with serial imaging frequently during the first 2 years after a dissection, and every 1-2 year afterwards. About your medicines, Lisinopril (ACE inhibitor), clonidine (a very strong anti hypertensive) and metoprolol (a beta blocker) all work to reduce blood pressure. Beta-blockers also work if you have rhythm problems with your heart. If your blood pressure is controlled, you may ask your doctor to review your medications and to adjust or stop clonidine. Even you have a normal body mass index (BMI=23.7, 175 pounds /6 feet), Simcor (Niaspan and simvastatin) is a cholesterol-lowering medication, which holds promise in lowering cholesterol levels even more, thus further helping prevent heart disease. If you have high cholesterol levels and tolerate flushing, hot flashes from Niaspan, you can continue to take the simcor. With excellent blood pressure control and conscious limits to physical activity, you can continue to lead long, full lives after a dissection. This would include returning to most jobs, but no work in physically demanding jobs such as construction, ect… Also while you are able to physically return to your previous physical conditioning and feel able to engage in strenuous activities such as sports, you should exercise caution. Strenuous activities such as sports will increase the stress on the aortic wall, increasing the risk for enlargement of the weakened aorta or even re-dissection. Mild exercise is usually considered OK. I would agree that alcohol in moderation is permitted and usually no more than 1 alcoholic beverage. Among other things, alcohol can affect or interact with some of the medications that you have suffered aortic dissections receive. Wish you good health.