Catheterization and Ring

[klp2]

Dear all,

My father 76 years old and 20 years diabetes , he have chf stage 3 last three month.
EF 20% from echo and LVEF 15% from nuclear/thalium test.
Doctor said "many part of his heart is good".

Today he is good without difficult breath and well sleeping.
but both his leg still swelling and difficult to walk making he stay on the bed much time.
Beside that he have gout in knee and ankle.

He has schedule for catheterization on April 18, 2013.
My question are:

1. is catheterization have risk?
2. From my undersatding after catheterization there are posibility to bypass,
   ring, baloon, or just medicine.
   is bypass, ring, or baloon specialy for ring have risk to be done for my father?
   I know that my father want just take medicine.

I hope he will be better.

Thank You.

[klp2]

Today he has little bit pain on right ankle and swelling.
His internist prescribed Furosemide injection but just for three days.
He get injection from my neighbor (nurse) doctor said all nurse can did it.
The Today my father meets doctor.  

Thank.

[jrbon]

Is he getting the Furosemide at home or in the hospital by vein? Is he urinating more than usual? Is his blood monitored?

You need to understand that the swelling in his legs might not be due to the heart. What does the Dr. say?.

How is his gout? The furosemide can aggravate it. Unfortunately most of the medication for the gout can aggravate the HF. He need to be carefully medicated.,

The Diabetes can produce peripheral vascular disease, which can produce fluid accumulation in the legs that will not respond to diuretics.

I am not a Dr. but If he is urinating good quantities and its blood analisys are good, the stents (rings) I do not think that will decrease the swelling, however it can increase its strength if really his heart needs more blood to work better.

Is the catheterization still in plan for tomorrow? If yes, you will find soon.

My thoughts are we you.

Jesus

[klp2]

My Father get Furosemide injection last three days.
But his legs still swelling.

Today I just concern about his swelling.

For breath I think well enough although he has to take deep breath for doing thing needing bit power.

Is ring/baloon cancan help him of swelling and give him more power to do something?

[jrbon]

As far as I can see Fumarate Acid it is not a diuretic. Bisoprolol Fumarate has and small diuretic activity.

The normal diuretic used for HF is Furosemide (Lasix).

Be aware that if he takes medicines for other problems (like ibuprofene) they can increase the fluid retention.

600ml of liquid per day it is very very litle (liquid includes all sort of liquids not just water) He should not drink that little without periodic blood tests to be sure that there is no kidney damage. The normal dose for heart patients is about 1200ml of total liquid per day.

Jesus

[klp2]

My father drink water only 600 mL everyday while doctor suggest 1600-2000 mL.
Is this (only 600 mL) that make swelling even he take 2X40mg furmaraete/deuretic?

[klp2]

Thank jbron,

Doctor said that my father have got silent heart attack on the past, so doctor want to know heart tissue still good or not by nuclear test.

After tested doctor said many part of my father heart is in good.

One month ago he stay for 2 week on hospital because got infection and  low blood pressure (60/40).

Now he is learning to walk because after gout and 2 week on bed/hospital.

But I am worry about his swelling and low blood pressure (around 85/60 - 90/70). He take 2X40mg Deuretic every day.

I just worry that I have to take decision regarding interventions.

is oral medication can help for him to have normal live and without swelling?

Thank you.

[jrbon]

1) Yes ALL interventions have risk, including catheterization.
2) Catheterization, balloon and rings (stents) are all made in the same intervention if adequate, so the risk it is similar to the catheterizarion alone.
3) Bypass is a different intervention, with more risks a longer recovery time, however the results are better in diabetic people.

How has the dr. determined that a big part of his heart is in good shape? Does he perform any Magnetic Resonance?

Jesus.