Fluid retention post CABG

[Sri2404]

Hi, My father (Age 58 years) went through a CABG X 2 on november 2010. When he came for his first checkup in jan 2011, x-ray report showed fluid accumulated in his lungs and hence went though pleural effussions. Yesterday was his second checkup and again some amount of fluid is accumulated. This time he is not admitted but has been asked to take lasix (he is taking it since cabg). Why is this fluid getting accumulated again and again. He is not taking more than 1 litre of fluids but again the problem is recurring. I think fluid accumulation is in the right side. Is it normal if fluid retention is recurring. Is there a way if the fluid can be removed so that we can avoid draining. He walks 3-4 kms every day and climbs 35 stairs daily. He rarely feels breathlessness (only for less than a minute once in a fortnight) and has no heart pain. His fasting blood sugar is 92, BP is 130/90 and Pulse rate is 62. Lipid test result and cholestral are within normal range. His EF during first checkup was 25-30%

[kenkeith]

When the EF is below 29% very often there is a failure of the heart to pump into circulation the amount of blood received from the lungs.  That may be intermittent or sustained for a longer period of time, and as result blood backs up into the lungs and fluids leak into the lung tissues causing pulmonary edema (fluid in the lungs).

Did your father have an enlarged left ventricle at the time of his CABG?  Does you father have an enlarged LV currently.  Usually when the LV is enlarged that will cause weaker than normal contractions and as a result the EF will be lower than normal.  Several years ago I had pulmonary edema and the symptoms were shortenss of breath, dry cough, hyperventalating and diagnoses was mild edema...so your father may not be having episodes that is medically significant other than there is a serious underlying cause.

Your father's heart may take more time to return to normal functionality with an EF of 50 to 70%...that is the amount of blood pumped with each heartbeat.  The EF can be increased medically and/or reducing the heart's workload giving it relief and more time to heal.  There are other causes for lung edema, but the low EF strongly indicates it is the left ventricle's ability to strongly contract to be the problem.

Hope this helps, and if you have any further questions or comments you are welcome to respond.  Thanks for the question, and I wish your father well going forward.  Take care,

Ken