Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
Hello doctor,
Patient is a 64-year-old male. He has a heart condition confined with a diagnosis CHF, and CVA infarct. He is now experiencing difficulty in breathing and swollen feet. He is currently taking Carvedilol, Aspirin, Furosemide, Captopril, Atorvastatin (old prescription). BP ranges140/120. Please advise.
Hello,
Welcome to icliniq.com.
He suffers from congestive heart failure and is taking medicines for that. You did not tell dosages of medicines.
His reports show (attachment removed to protect patient identity) he also has raised creatinine and urea levels which may be due to varied causes. It may be due to reduced blood supply to kidneys due to heart failure or may be due to over diuresis. Or it may be due to any angiography/plasty done in the past. Or even it may be due to intrinsic renal problem.
He has shortness of breath and swollen feet means he suffers from the left and right ventricular failure, but you did not send her echocardiography and did not tell ejection fraction.
Left and right ventricular failure.
Investigations to be done:Echocardiography (ECG), NT-Pro BNP (B-type natriuretic peptide), urine D/R.
Probable diagnosis:Biventricular failure.
Treatment plan:Admission to HDU or ward as oxygen may be needed. Increase dose of Furosemide preferably intravenous dose. Monitoring Intake and output
oral Indapamide, it also increases urine output. If renal function is deteriorating then stop Captopril and start Hydralazine 50 mg thrice a day plus Isosorbide dinitrite 20 mg thrice a day.
Avoid excessive liquid intake. Avoid excessive salt intake. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) such as Ibuprofen, Diclofenac (painkillers). Avoid steroids. Avoid sleeping in flat position rather adopt propped up position at 45 degrees.
Regarding follow up:Follow up after five days.
Was this answer helpful?
|This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.
Comprehensive Medical Second Opinion.Submit your Case
Are cold with chest pain and fatigue symptoms of pneumonia?
Query: Hello doctor, I am an 18-year-old female. I have a cold with chest pain, fatigue and difficulty breathing for three days up till now, without physically consulting a doctor. I have had pneumonia last year and I am afraid that I might get again as I am starting to show some symptoms of pneumonia. Sh... Read Full »
I am suffering from lack of sleep and anxiety. What is the treatment?
Query: Hello doctor,Recently I am suffering from lack of sleep and anxiety, last night I could not sleep at all because of restlessness and from a couple of days. I have been sleeping less for like two to three hours in the night. I am also suffering from anxiety, where I sweat a lot and become restless. P... Read Full »
What are the causes for headaches and swollen feet?
Query: Hello doctor, I am wondering if anyone would know what is wrong or what other tests can be done. My ANA is 1:360, TSH is 0.5, free and total, T3 and T4 are normal. SLE (systemic lupus erythematosus) is negative, Sjorgen's is negative, and thyroid ultrasound is normal. Symptoms experienced are extrem... Read Full »
Ask your health query to a doctor online?
Ask a Cardiologist Now