quick question...

[sylviayasgur]

hi all,
my dad had avr almost 7 years ago along with double bypass surgery. he is in chronic afib and takes coumadin (has a st.jude's valve).

he now needs to have his mitral and tricuspid valves repaired and has decided to have dr. colvin at nyu do this procedure minimally invasive. he just has to set a date.

this weekend he went out for thai food and felt sick all night long, unable to sleep. he vomited at 4 am after which he was finally able to fall asleep.
the next morning he awoke with what looked like capilaries along his cheek.
he thought his pt/inr might be too high and went in to be tested. it's 2.6, just fine for him (although it had been low a few weeks ago and they upped his coumadin).
i suggested he take benadryl, thinking maybe it was an allergic reaction to something in the food, but the "rash" or what looks like broken capillaries on the side of his cheek did not disappear.
he joined us for dinner last night and had what he usually has at the restaurant, and , once again, was up all night feeling ill.
he awoke today feeling very full and constipated and my mom is very nervous.
he, supposedly, still has the remains of a hematoma and he has been told that his tricuspid valve is leaking into his stomach area....

i am just wondering if any of this could be heart- related.
i got nervous thinking he might have an aneurysm or something serious, but he had an echo done 6 weeks ago and that showed only the leaking valves.

if anyone has any other suggestions or ideas or knows about this, i could surely use your input.
thanks so much. i know i worry a lot, but i guess it's part of this deal.
be well,
sylvia

 

[Georgia]

Maybe he broke the capillaries while vomiting?

I had serious digestive trouble when I had chf just before I was diagnosed. Felt nauseous and "full" all the time. With the mitral and tripcuspid combination - the same as I had - I wonder if he might be retaining huge amounts of fluid (ascites?). Sure sounds like you ought to get him in to the doc.

Best of luck.

 

[Ross]

Sylvia an echo isn't a very good diagnostic tool. It's like a first step in a sequence of tests to find out everything. It doesn't sound like an aneurysm to me, but there is something seriously wrong with this picture. If it were my dad, he'd be getting a trip to the doctor and possibly ER.

 

[Nancy]

Sylvia-

Joe has a severely leaking tricuspid and they don't want to operate on him. When he has fluid backup it goes to ascites (stomach area fluid). He also gets congested liver and his spleen can get enlarged too. That combination can make Joe nauseous. And the worst thing is that when there is stomach area involvement, his diuretics hardly work at all.

Here is a link from the Texas Heart Institute which outlines that very thing.

http://www.texasheartinstitute.org/HIC/Topics/Cond/vtricus.cfm

This is one of the reasons we keep his sodium restriction so severely low. i don't want that kind of ascites involvement with him. It causes way more problems than just fluid in the extremities.

The Thai food may have had too much sodium and monosodium glutamate in it. Perhaps it threw him into some kind of ascites fluid overload.

I think if it is continuing, I would get him into the doctors to have a look at him, and maybe test him with a BNP.

Does his stomach area look engorged and does he have a very full feeling, and does his liver or spleen areas look large?

 

[sylviayasgur]

thanks so much for your replies.
my mother took my dad to his internist on wed. morning and the doctor said it was probably a stomach bug. his cheeks were looking better but not entirely clear yet.
he felt well enough to go to the berkshires for the weekend, so i'm sure i'll find out how he is once he returns (they haven't called and i'm assuming no news is good news).
thanks again for all your help (and i DO think he should look into it more),
sylvia

 

[Ross]

You can lead the horse to water, but you can't make him drink.

 

[catwoman]

Sylvia:

Hope your dad is feeling better now.
Re: the broken capillaries -- I have frequently had problems with broken blood vessels after vomiting. I've even looked like I had the measles, complete with speckles on my eyes. This was years pre-op, so it had nothing to do with being on warfarin.

While my niece was attending Boston U., I frequently visited her and traveled through the Berkshires. Beautiful part of Massachusetts and great area for antiquing.

 

[sylviayasgur]

thanks again, all!
ross, you are 100% right!!!!
hope you are all doing well,
sylvia

 

[Ross]

thanks again, all!
ross, you are 100% right!!!!
hope you are all doing well,
sylvia

Well not really, but as well as I can. Thanks for asking.