Meds? Naseau and dizziness

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bbb

bbb

Well-known member
Joined
Oct 11, 2007
Messages
179
Location
Southwest
Hi,
In the ongoing saga of my friend David and his endocarditis....he had a mitral valve repair 2 weeks ago....Anyway, for the past 3 days he has been feeling so naseous and dizzy that he can barely get out of bed. Also very, very tired. The only time he does not feel dizzy is when he is laying down. I finally got him an appt. for tomorrow morning, with a nurse practioner for the cardiologist and also talked to his infectious disease doctor. We all have the feeling it is probably from the medication. He is on Amiodarone, coumadin, lasix, metroprolol, aspirin, colace, and IV Rocefrin. Anyway, we will have that all checked out tomorrow (maybe he can get of the Amiodarone and I'm sure he does not need the lasix anymore, anyway will get the professional advice). I'm also wondering if it could be anything like anemia, or fluid around the heart, etc.

My question is, did anyone ever experience this and if so, what was the cause?

Thanks!! Betsy
 
I'd get him to ER and not wait until the morning. I was feeling lethargic and dizzy (nauseous) when I had fluid around my heart and ended up with Pericardial Tamponade. I called my doc who told me to go to the ER immediately, which I did. It was a good thing I did. I ultimately had to go into surgery to get the fluid drained. My surgeon told me had I left it much longer I could have died due to conjestive heart failure from the pressure. I don't want to alarm you but it's better to be safe than sorry. It was also in my second week post-op after a mitral valve repair.
 
Wayne,
Did you have shortness of breath? David doesn't seem to be able to really isolate whether he is SOB or not, he say he just is very tired, but he did a 10 min walk today. I just called the nurse and asked her about fluid around the heart and she thought we could wait until the morning unless he felt he should go to the ER. I also talked with David and he does not want to go to the ER and feels he can wait until the morning. So, I will keep you posted...

Betsy
 
I had difficulty breathing but didn't immediately recognize it as SOB. I thought it was because my chest was still very sore from the surgery. I was asymptomatic pre-op so didn't really relate to symptoms like SOB. I was doing walking, but as it was winter here all I did was brief walks around the main floor of my house at that time. I was feeling really tired, lethargic, and bloated but not knowing how I was supposed to be feeling after OHS, I just figured this was how I was supposed to feel post-op and from the meds. I had never been seriously ill and injured before so had no idea what recovery was supposed to feel like. Unfortunately, I was wrong and because I didn't seek help soon enough I was beyond the point where meds could control the fluid so I ended up in the OR to get surgically drained, got two more surgical scars for my collection, and endured another week admitted to the hospital. My surgeon scolded me for not calling sooner if I was unsure about how I was feeling. He advised that if in doubt always call.
 
I also just read the Pericardial Tamponade rarely happens when someone is on anticoagulation therapy. So, hopefully this is not what David has...will keep you posted.

Betsy
 
Betsy i'm sorry i am not much help to answer

your questions .....but if in dought don't hesitate

to check it out and if you can i would not wait till

morning if you can check it out now,you should.

just want to say you both are in my prayers.

zipper2 (DEB)
 
Hi Betsy,

So sorry to hear David's experiencing such lousy symptoms. I was on Coumadin, Metoprolol and Amiodarone, but the other meds you mentioned. During my third week post op, I had day, out of the blue, when I couldn't get out of bed due to dizziness. If I stayed flat in bed, I was better and that enabled me to avoind the nausea that came with staying in a dizzy state for too long. Mine got better by the end of the day and hasn't returned. 3 days is troubling. I'd suggest he see someone ASAP. Can't be too careful.
 
bbb said:
I also just read the Pericardial Tamponade rarely happens when someone is on anticoagulation therapy. So, hopefully this is not what David has...will keep you posted.

Betsy
Click to expand...

Actually I was on coumadin at the time I had the Pericardial Tamponade. Although I had a valve repair and didn't have to take coumadin forever, it is typical to take it for the first 90 days post-op as a precaution in those early weeks of recovery. In fact, it was when I called the doctor's office about my INR results and next dosage that I mentioned how I was feeling and was told to go to the ER immediately. I hope David doesn't have it, but from my experience being on coumadin doesn't prevent it.
 
Interesting Wayne... So David went to cardiologist today and he was taken off the amiodarone and the lasix. The cardiologist kept talking about the idea that depression was common after ohs, but I asked if this would cause dizziness and naseau and he said maybe a little???!! Anyway, he also said that he had just had endocarditis, a stroke and then OHS, so he probably won't feel great for a while. I asked about the fluid around the heart and he said he definitely did not think it could be that. Something about the pericardium being removed??? He was not totally inspiring confidence in us in all statements, but at least he took him off Amiodorone and Lasix and pointed out that he has been through the mill.

We see the GP tomorrow, and then the infectious disease doc, so I will still see if fluid around the heart is a possiblilty. David did seem to feel a bit better today, we were at docs for 4 hours total and he was maybe 40% of the time rolling with the flow. So, will keep you posted on the results of tomorrow.

Thanks, Betsy
 
Good thing he's getting additional opinions. Something doesn't sound quite right with what he's been told about depression being the cause, or about the pericardium. How I recall my problem being explained to me by my Cardio and Surgeon (separately, not together) was that during the OHS the pericardium is breached and sometimes, but not always, the body will react by generating fluid as essentially a counter measure. That results in the fluid build up around the heart and ultimately pericardial tamponade if the pressure builds up so much that CHF occurs. I can't remember their exact words as at the time I was quite under duress, but that how I recall the drift of it. Anyway, I hope it all goes well for David.

I forgot to mention, has he had any weight gain? That was also one of the signs. In my case I had lost quite 15 lbs while in the hospital. I regained most of that when I got the pericardial tamponade due to the fluid build up. However, silly me thought I just was regaining my normal weight....I should have clued in that I was eating like a bird so why was I gaining weight? The meds kind of dull the brain....or was it the "pump head" :rolleyes: After the surgical drain, I lost the weight again.
 
Hi Betsy

I had a very similar experience to Wayne, ending up back in hospital with pericardial tamponade and the exact symptoms he has described.
Plus I had terrible nausea - I could not eat or drink. Generally I just felt terrible. The bloating and sudden weight gain can be a symptom that alerts the doctors to fluid around the heart.

I was/am on Warfarin too.

I hope your friend starts to get some answers and feel better soon. He's lucky to have you to advocate for him.

Bridgette
 
He has not had weight gain, he has stayed at the same weight the past week, about 20lbs less than normal. He does not have any swelling or bloating.

How do they diagnose the pericadial tamponade? Can they hear by listening to the heart? He had an EKG and the cardio said everything seemed fine with his heart. I don't think he has anything of the below signs, but will check with the other doc today.

I just looked up the following signs of Pericardial Tamponade:
* Blood pressure may fall (pulsus paradoxical) when the person inhales deeply
* Breathing may be rapid (faster than 12 breaths in an adult per minute)
* Heart rate may be over 100 (normal is 60 to 100 beats per minute)
* Heart sounds faint during examination with a stethoscope
* Neck veins may be abnormally extended (distended) but the blood pressure may be low
* Peripheral pulses may be weak or absent


Thanks, Betsy
 
They can confirm a diagnosis of percardial tamponade by chest x-ray and echo. That's what happened in my case anyway.

Good luck
Bridgette
 
bbb said:
I just looked up the following signs of Pericardial Tamponade:
* Blood pressure may fall (pulsus paradoxical) when the person inhales deeply
* Breathing may be rapid (faster than 12 breaths in an adult per minute)
* Heart rate may be over 100 (normal is 60 to 100 beats per minute)
* Heart sounds faint during examination with a stethoscope
* Neck veins may be abnormally extended (distended) but the blood pressure may be low
* Peripheral pulses may be weak or absent
Click to expand...

I don't know about all of these but I remember I had low BP and barely a pulse. I don't recall breathing rapid, except to catch my breadth after doing my walking or streching exercises (as I mentioned previously, I was having some difficulty breathing).

BTW, I didn't have any physical swelling or bloating that I can recall. I did however "feel" bloated....kind of that full feeling like when you are constipated. I thought it was from the meds.
 
Hi Betsy,
I am just reading your posts and wanted to add that Ryan experienced dizziness and nausea when he was home after having a very similar experience to David (endocarditis, valve replacement, IV antibiotics for 8 additional weeks!) His body was just worn out and was not able to do the same amount of post-op exercise as most. Also he got really dizzy being on the Lasix as it did its job too well and made him dehydrated and messed up his electrolytes making him weak and nauseous as well. We did have several tests to rule anything else out as he did have lots of fluid in his chest right after the surgery but did feel better after being off the Lasix.
Hope he gets relief soon,
Theresa
 
Well, we went to GP today and infectious disease doc and the GP took him off Metroprolol, he checked his BP when he was standing and it was lower, so he thinks it is the beta blocker. David was doing much more today and not constantly lying down, he was up and around 75% of the day, so I definitely see an improvement since he has come off some of the meds, esp. lasix, amiodarone and metropolol. The docs also suggested that because he had a stroke from embolic vegetation from the endocarditis going to his brain, he could still be experiencing some effects of the stroke. He still has some vision and focus issues and walking is a bit difficult because of that.

We'll see if he starts to feel better over the next few days, but I think the meds were part of the culprit.

Thanks! Betsy
 
A bit of poor wording has created a false impression.

What Wikipedia is saying is that aortic dissection and ACT can be rare causes of cardiac tamponade, not that it rarely occurs in conjuntion with them. I suspect it's a case of British usage playing with the American mind (note the proper, Greek spelling of uremia, the use of "whilst").

Not an unusual turn of the British phrase, but to an American, the wording is correct, but it ain't right:
...but can also be caused by myocardial rupture, cancer, uraemia, pericarditis, or cardiac surgery,[2] and rarely occurs during aortic dissection,[4] or whilst the patient is taking anticoagulant therapy.[5]
Click to expand...
In fact, it seems to make not a whit's difference whether you are anticoagulated or not. Here's a study: http://headandneckca.asco.org/ASCO/...w=abst_detail_view&confID=55&abstractID=32755
...and the key outcome statement:
There was no significant difference between the tamponade and non-tamponade patients in the proportion of patients defined as "anticoagulated"
Click to expand...

...So, please don't think that you are either protected or more vulnerable to cardiac tamponade due to anticoagulation therapy.

Best wishes,
 
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