The Doctor is In :-)

O Doctor! doctor!
Can you mend a broken heart..?

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

http://www.heartmdphd.com/chat.asp

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Peter Jason said:

O Doctor! doctor!
Can you mend a broken heart..?

I can try :-)

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Hi Dr Chung:

Thanks for advising on my mother's echo report earlier (that it was not
serious and you're right). My mother is hospitalized again after her
last CHF (3 weeks ago) due to severe shortness of breath and fluid in
lungs. This time the diagnosis is that her heart is functioning okay,
the lungs are clear but she has been losing sodium over the last year.
The doctor said she did not have a heart attack, now they just have to
find out what caused the dropping sodium level. Since hospitalized last
Thursday they cut back her meds :Tiazac (from 240 to 180) coumadin down
from 2mg to 1 or 1.5mg, and they held Atenolol (gave her lazik), and her
sodium has come back up from 118 to 132 (4 days) and she's doing much
better now.

My question: Was it still consider CHF though it wasnt the heart that
failed her but the low sodium? Since these sounds like two different
problems. And if her heart is fine (she has irregular heart rate for a
long time and the doctor said not to worry about it now) why is she
taking heart medicine? I asked the doctor if it was SIADH and he
doubted it, said it could be some sort of hormone imbalance. I'm sorry
if I've got the facts a bit confused as I am still learning from the
pros in hospital and as much as I can from the web plus running back and
forth from hospital. I would really appreciate your help and comments.

Thank you very much, V. Chow

Dr. Andrew B. Chung said:

http://www.heartmdphd.com/chat.asp

Quoted message said:

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

vivian said:

Hi Dr Chung:

Thanks for advising on my mother's echo report earlier (that it was not
serious and you're right).

You are welcome.

Quoted message said:

My mother is hospitalized again after her
last CHF (3 weeks ago) due to severe shortness of breath and fluid in
lungs.

Sorry to hear this.

Quoted message said:

This time the diagnosis is that her heart is functioning okay,
the lungs are clear but she has been losing sodium over the last year.

What were her symptoms?

Quoted message said:

The doctor said she did not have a heart attack, now they just have to
find out what caused the dropping sodium level. Since hospitalized last
Thursday they cut back her meds :Tiazac (from 240 to 180) coumadin down
from 2mg to 1 or 1.5mg, and they held Atenolol (gave her lazik), and her
sodium has come back up from 118 to 132 (4 days) and she's doing much
better now.

132 is still low.

Quoted message said:

My question: Was it still consider CHF though it wasnt the heart that
failed her but the low sodium?

With the lungs being clear (no congestion), this would not be CHF.

Quoted message said:

Since these sounds like two different
problems. And if her heart is fine (she has irregular heart rate for a
long time and the doctor said not to worry about it now) why is she
taking heart medicine?

My guess is that by "fine," her doctors are trying to say that her heart is
not causing the problems this time.

Quoted message said:

I asked the doctor if it was SIADH and he
doubted it, said it could be some sort of hormone imbalance. I'm sorry
if I've got the facts a bit confused as I am still learning from the
pros in hospital and as much as I can from the web plus running back and
forth from hospital. I would really appreciate your help and comments.

Has your mom been taking any herbal preparations with diuretic properties
(green tea for example)? In susceptible individuals, this can cause low
sodium (hyponatremia). Chronic pains can also cause hyponatremia (from
SIADH).

Quoted message said:

Thank you very much, V. Chow

You are very welcome :-)

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

Dr. Andrew B. Chung said:

Quoted message said:

This time the diagnosis is that her heart is functioning okay,
the lungs are clear but she has been losing sodium over the last year.

What were her symptoms?

Her bloodtest of Last January showed a sodium deficiency but her family
was not really concerned but told her to take in more salt !

She has been very tired and lack of energy since then, I have no reason
to believe it has any relation but she was also prescribed with coumadin
2mg a few months earlier

Quoted message said:

Quoted message said:

The doctor said she did not have a heart attack, now they just have to
find out what caused the dropping sodium level. Since hospitalized last
Thursday they cut back her meds :Tiazac (from 240 to 180) coumadin down
from 2mg to 1 or 1.5mg, and they held Atenolol (gave her lazik), and her
sodium has come back up from 118 to 132 (4 days) and she's doing much
better now.

132 is still low.

yes

Quoted message said:

Quoted message said:

My question: Was it still consider CHF though it wasnt the heart that
failed her but the low sodium?

With the lungs being clear (no congestion), this would not be CHF.

Oh, I mean her lungs are clear after the fluid has been drawn out....she
does not have any damages in her lungs other than the fluid build up
which was a temporary disorder.

Quoted message said:

Quoted message said:

Since these sounds like two different
problems. And if her heart is fine (she has irregular heart rate for a
long time and the doctor said not to worry about it now) why is she
taking heart medicine?

My guess is that by "fine," her doctors are trying to say that her heart is
not causing the problems this time.
\

Is there any effective medication for irregular HR for her age (82)?

Quoted message said:

Quoted message said:

I asked the doctor if it was SIADH and he
doubted it, said it could be some sort of hormone imbalance. I'm sorry
if I've got the facts a bit confused as I am still learning from the
pros in hospital and as much as I can from the web plus running back and
forth from hospital. I would really appreciate your help and comments.

Has your mom been taking any herbal preparations with diuretic properties
(green tea for example)? In susceptible individuals, this can cause low
sodium (hyponatremia). Chronic pains can also cause hyponatremia (from
SIADH).

My mother does not take caffeine or strong tea or coffee. No herbal tea
But she always have discomfort (no pain tho) in her feet that keeps her
from sleeping well at night. The doctor said it wasnt arthritis but a
case of deterioration due to aging.

Quoted message said:

Quoted message said:

Thank you very much, V. Chow

You are very welcome :-)

Really appreciate it. Thanks and look forward to hearing from you
again.

V.

Quoted message said:

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

vivian said:

Dr. Andrew B. Chung said:

Quoted message said:

This time the diagnosis is that her heart is functioning okay,
the lungs are clear but she has been losing sodium over the last year.

What were her symptoms?

Her bloodtest of Last January showed a sodium deficiency but her family
was not really concerned but told her to take in more salt !

She has been very tired and lack of energy since then, I have no reason
to believe it has any relation but she was also prescribed with coumadin
2mg a few months earlier

For stroke prevention in the setting of atrial fibrillation (irregular heartbeat?)
?

Her symptoms would raise the concern about anemia since she was anticoagulated on
coumadin.

Quoted message said:

Quoted message said:

Quoted message said:

The doctor said she did not have a heart attack, now they just have to
find out what caused the dropping sodium level. Since hospitalized last
Thursday they cut back her meds :Tiazac (from 240 to 180) coumadin down
from 2mg to 1 or 1.5mg, and they held Atenolol (gave her lazik), and her
sodium has come back up from 118 to 132 (4 days) and she's doing much
better now.

132 is still low.

yes

Quoted message said:

Quoted message said:

My question: Was it still consider CHF though it wasnt the heart that
failed her but the low sodium?

With the lungs being clear (no congestion), this would not be CHF.

Oh, I mean her lungs are clear after the fluid has been drawn out....she
does not have any damages in her lungs other than the fluid build up
which was a temporary disorder.

Low sodium (or hyponatremia) typically does not cause CHF. However, CHF can lead
to hyponatremia.

Quoted message said:

Quoted message said:

Quoted message said:

Since these sounds like two different
problems. And if her heart is fine (she has irregular heart rate for a
long time and the doctor said not to worry about it now) why is she
taking heart medicine?

My guess is that by "fine," her doctors are trying to say that her heart is
not causing the problems this time.
\

Is there any effective medication for irregular HR for her age (82)?

Yes. These medications primarily help by controlling (slowing) heart rate.

Quoted message said:

Quoted message said:

Quoted message said:

I asked the doctor if it was SIADH and he
doubted it, said it could be some sort of hormone imbalance. I'm sorry
if I've got the facts a bit confused as I am still learning from the
pros in hospital and as much as I can from the web plus running back and
forth from hospital. I would really appreciate your help and comments.

Has your mom been taking any herbal preparations with diuretic properties
(green tea for example)? In susceptible individuals, this can cause low
sodium (hyponatremia). Chronic pains can also cause hyponatremia (from
SIADH).

My mother does not take caffeine or strong tea or coffee. No herbal tea
But she always have discomfort (no pain tho) in her feet that keeps her
from sleeping well at night. The doctor said it wasnt arthritis but a
case of deterioration due to aging.

Could be poor circulation in the lower legs and feet (peripheral vascular
disease).

Quoted message said:

Quoted message said:

Quoted message said:

Thank you very much, V. Chow

You are very welcome :-)

Really appreciate it. Thanks and look forward to hearing from you
again.

Glad to help.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com