advertisement
Question
Posted by: LM | 2011-05-05

HEART FAILURE

Dear Dr,

My husband is 51 years old and stopped smoking 3 weeks ago. A few days after he stopped smoking he had problems breathing and ran out of breath very fast. After a few days he felt worse and went to the Dr who immediatly after ECG had him admitted to hospital.

Diagnosed with Heart failure. MRI scan and Angiogram was done. Cholesterol levels low 3.8 did not need stents or by pass. Biopsy was done awaiting results, hoping to see the Cardiologist tomorrow.

What i need to know plse is there any replacement tablets for Warfarin as his levels are between 4.8 and 1.6 at the moment, getting the blood tested often is very difficult.

I also need to know why must fluid be restricted. He does not drink any alcahol (stopped a few years ago) his blood pressure is under control. I am controling his salt intake, have reduced cooking with salt to the minimum. He follows very healthy eating plan.

He is 1.65 tall and weighs 53kg. He has never been over weight. He is on 1x6.25 mg Cardloc, Wafarin, 1/2 Spiractrim every 2nd day, 2.5mg Lanoxin and Prexum 4mg every day. Once the tablets kick in and he starts feeling better will the fluid intake still be restricted?

He is struggling to get used to it. He loves Rooibos tea, coffee and water and cooldrink. Any advise you can give will be appreciated. thank you.

Kind Regards

Not what you were looking for? Try searching again, or ask your own question
Our expert says:
Expert ImageCardiologist

Hi LM

From what you have told me I assume your husband has atrial fibrillation, which either precipitated or aggravated heart failure, plus a degree of left ventricular dysfunction, which is why a biopsy was done.

The reason he has been started on warfarin is to protect him from the risk of stroke, which is a fairly common - and disastrous - complication of atrial fibrillation with heart failure.

The usual answer to your question - is there an alternative to warfarin - is no, there is no alternative to warfarin in this situation. However, there is now a new drug called dabigatran (Pradaxa) which has been approved in N American and Europe as an alternative to warfarin in patients like your husband.

It is more effective and safer than warfarin, and does not need to be monitored with blood tests (INRs) It is available in RSA, although it has not yet been approved by the MCC for this condition, and is also at this stage very expensive (R2000 or more per month, not covered by medical aid.) So for most people warfarin is the only suitable drug.

Fluid should be restricted in heart failure mainly in those patients with low serum sodium levels and/or kidney disease. For patients with normal sodium levels and normal kidney function, salt (sodium) restriction is usually all that is necessary. "Take care of the salt and the sodium [concentration] will look after itself" - with the help of the kidneys. However I would be guided by your husbands cardiologist.

I hope things go better for your husband

Best wishes

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

1
Our users say:
Posted by: Cardiologist | 2011-05-09

Hi LM

From what you have told me I assume your husband has atrial fibrillation, which either precipitated or aggravated heart failure, plus a degree of left ventricular dysfunction, which is why a biopsy was done.

The reason he has been started on warfarin is to protect him from the risk of stroke, which is a fairly common - and disastrous - complication of atrial fibrillation with heart failure.

The usual answer to your question - is there an alternative to warfarin - is no, there is no alternative to warfarin in this situation. However, there is now a new drug called dabigatran (Pradaxa) which has been approved in N American and Europe as an alternative to warfarin in patients like your husband.

It is more effective and safer than warfarin, and does not need to be monitored with blood tests (INRs) It is available in RSA, although it has not yet been approved by the MCC for this condition, and is also at this stage very expensive (R2000 or more per month, not covered by medical aid.) So for most people warfarin is the only suitable drug.

Fluid should be restricted in heart failure mainly in those patients with low serum sodium levels and/or kidney disease. For patients with normal sodium levels and normal kidney function, salt (sodium) restriction is usually all that is necessary. "Take care of the salt and the sodium [concentration] will look after itself" - with the help of the kidneys. However I would be guided by your husbands cardiologist.

I hope things go better for your husband

Best wishes

Reply to Cardiologist

Have your say

Thanks for commenting! Your comment will appear on the site shortly.
Thanks for commenting! Your comment will appear on the site shortly.
advertisement