Dr. Isaac Gana
Cardiology
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Patient's Query
Hello doctor,
I have congestive heart failure (heart failure with preserved ejection fraction - HFpEF) diagnosed by stress echocardiography test where E/E' ratio was 11 at rest, and E/E' ratio increased to 15 post-exercise. There are frequent episodes of oxygen desaturation whenever the heart is stressed or at rest. The HR goes up to 125 and then starts falling rapidly. I am also diagnosed with tachy-Brady syndrome and implanted with a DDR-CLS dual-chamber pacemaker. Could you please explain the frequent episodes of oxygen desaturation under CHF conditions and when I start becoming symptomatic? My lungs are normal as per the latest HRCT chest.
Hello,
Welcome to icliniq.com.
Based on my experience in similar cases, people that have mild or moderate CHF (congestive heart failure) do not have oxygen desaturation at rest or stress. It is usually when there is an associated lung disease, which you said there is not, or when there is the presence of severe heart failure. The best way forward regarding the management of his condition must include oxygen therapy while being monitored with an oxygen pulse oximeter for some time.
Patient's Query
Thank you doctor,
I hope you have seen the attached reports for correlation to come to a diagnosis and conclusion. What is your diagnosis based on the reports attached?
Hello,
Welcome back to icliniq.com.
I went through all the attached reports (attachment removed to protect patient identity). My diagnosis based on the evidences you provided and complaints is sick sinus syndrome with congestive heart failure secondary to hypertensive heart disease.
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Cardiology
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