It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Heart Disorders Message Board
Post New Thread   Reply Reply
LinkBack Thread Tools
Old 03-19-2013, 07:15 PM   #1
Newbie
(female)
 
Join Date: Mar 2013
Posts: 3
Countrygal68 HB User
Diastolic heart failure

61 y/o female with large left pleural effusion and new diagnosis of diastolic heart failure. Had thoracentesis done 2 weeks ago and had 1100 cc off left lung and 800 cc off right. As of today, large effusion on left side again, and female is more dyspneic and morning oxygen sats 86%. What else could be going on beside the heart failure? Pleural fluid is benign and gram stain shows nothing.

 
Reply With Quote
Old 03-20-2013, 12:30 AM   #2
Senior Veteran
(female)
 
ladybud's Avatar
 
Join Date: Jun 2012
Location: Colorado
Posts: 5,002
ladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB User
Re: Diastolic heart failure

I don't quite know what diastolic failure is, but am very familiar with CHF in general. Some questions- did this occur suddenly? Did she have a precipitating MI or are there any valve problems, lung problems like COPD or pulmonary emboli? Does she have the usual symptoms of CHF like enlarged heart, edema in feet, etc? One thought would be CHF due to pulmonary emboli. She could also have very low albumin causing fluid to shift from the blood to the alveoli. Did she suddenly go into renal failure? Is her BNP quite high? Any underlying connective tissue disease causing pleuritis? What is heart size on chest xray? You sound medical, so some of these pieces of info could help as to cause.

 
Reply With Quote
Sponsors Lightbulb
   
Old 03-20-2013, 04:28 PM   #3
Newbie
(female)
 
Join Date: Mar 2013
Posts: 3
Countrygal68 HB User
Re: Diastolic heart failure

[QUOTE=ladybud;5149580]I don't quite know what diastolic failure is, but am very familiar with CHF in general. Some questions- did this occur suddenly? Did she have a precipitating MI or are there any valve problems, lung problems like COPD or pulmonary emboli? Does she have the usual symptoms of CHF like enlarged heart, edema in feet, etc? One thought would be CHF due to pulmonary emboli. She could also have very low albumin causing fluid to shift from the blood to the alveoli. Did she suddenly go into renal failure? Is her BNP quite high? Any underlying connective tissue disease causing pleuritis? What is heart size on chest xray? You sound medical, so some of these pieces of info could help as to cause.

The shortness of breath came on very suddenly-couldn't lay flat one night. Has no previous heart history. She had an echocardiogram which was normal other than some trivial regurgitation. She is a pack a day smoker for 35 years. Slight edema occ. in lower ext. Labs are grossly normal. BNP is normal. She has had some episodes of bronchitis 1-2 times a year. She is going to have a consult with cardiology this week. Will see what they have to say. Symptoms all point to CHF but is not the typical case. She has had oxygen 1.5 L on at night and desats to low 80's by morning. There has to be something else going on besides the DHF. I think they may need to go into the lung and possibly biopsy or ? She is newly diagnosed hypertension and wonder if pressures have something to do with all of this. It's puzzling.

 
Reply With Quote
Old 03-20-2013, 06:39 PM   #4
Senior Veteran
(male)
 
Machaon's Avatar
 
Join Date: Feb 2003
Location: Fort Laud
Posts: 3,997
Blog Entries: 22
Machaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB UserMachaon HB User
Re: Diastolic heart failure

Quote:
Originally Posted by Countrygal68 View Post
The shortness of breath came on very suddenly-couldn't lay flat one night.
I'm 70 and I've had diastolic heart failure for over 25 years. Shortness of breath was my most significant and serious symptom. When I was much worse, and the heart failure was spreading into my ventricles, I had to sit up straight all the time, including sleeping and watching tv.

Quote:
Originally Posted by Countrygal68
61 y/o female with large left pleural effusion ...
I've never had a pleural effusion. When I was much worse, I would frequently get an pericardial effusion of < 1 cm, if I lay on my side, or flat on my back. Currently, I can fully recline on my back, or my sides, without problem.

My condition had worsened as I approached age 60. Fortunately, through avoiding irritants and stimulants, healthy diet, appropriate exercise and Coreg (Carvedilol) my DHF and health have gotten much better.

I've always had normal blood oxygen readings.

Quote:
She is a pack a day smoker for 35 years.
Hopefully, this fact won't turn out to be the smoking gun!

Quote:
She is newly diagnosed hypertension and wonder if pressures have something to do with all of this. It's puzzling.
How actively had she been monitoring her blood pressure? If she only had her blood pressure taken during the morning hours, she might not have been aware of a blood pressure problem.

I hope her health problems are resolved quickly and fully, and I wish both of you the best of health and luck.
__________________
CHF, A-Fib, HBP, Diabetes, Asthma doing great

⇒ Avoid allergic & non-allergic irritants/triggers
⇒ Low calorie ovo-vegetarian diet
⇒ Power walk, weight lifts, pushups
⇒ Coreg 25mg bid

Last edited by Machaon; 03-20-2013 at 06:47 PM.

 
Reply With Quote
Old 03-23-2013, 06:54 PM   #5
Senior Veteran
(female)
 
ladybud's Avatar
 
Join Date: Jun 2012
Location: Colorado
Posts: 5,002
ladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB Userladybud HB User
Re: Diastolic heart failure

I would agree that the the sudden onset of dyspnea, and huge pleural effusions are atypical of heart failure. Any chance she has a lung malignancy that was obsured by the pleural effusion? Lupus can cause pleural effusions, and be associated with anti-phospholipid syndrome that can cause pulmonary thrombosis or pulmonary embolism. Have they done a CT scan of chest? D-dimer test or VQ scan? She sounds pretty sick. I hope the etiology is figured out soon so she can get the best treatment.

 
Reply With Quote
Old 03-23-2013, 10:52 PM   #6
Newbie
(female)
 
Join Date: Mar 2013
Posts: 3
Countrygal68 HB User
Re: Diastolic heart failure

Quote:
Originally Posted by ladybud View Post
I would agree that the the sudden onset of dyspnea, and huge pleural effusions are atypical of heart failure. Any chance she has a lung malignancy that was obsured by the pleural effusion? Lupus can cause pleural effusions, and be associated with anti-phospholipid syndrome that can cause pulmonary thrombosis or pulmonary embolism. Have they done a CT scan of chest? D-dimer test or VQ scan? She sounds pretty sick. I hope the etiology is figured out soon so she can get the best treatment.
Well, another thoracentesis was done on Friday morning. They drained just as much off the lungs as 2 weeks ago. The pulmonologist was concerned that she returned so quickly since she was scheduled for a 6 week check up. Yes, she has had 2 chest CTs and the Dr. thought the CT on Friday looked better than 2 weeks ago. They are now testing the pleural fluid again to see if it shows anything different. She is scheduled for a CXR in one week. If the lungs show fluid build up again then she will be hospitalized for additional testing. A lung malignancy has been on my mind and that is something I'm sure the Dr.s are considering. The pulmonologist doesn't think this is cardiac. The patient will have an appointment with a cardiologist on Tuesday and maybe he will have some new insight to all of this. This female is my oldest sister and she is quite sick and we are all very concerned about her. I am an RN as is another sister of mine. It's frustrating that nobody really knows what the problem is. We have been researching and reading to try and find out what this could all mean. If it isn't cardiac then I'm not certain why the #1 diagnosis she went home with is Acute diastolic heart failure with preserved ejection fraction?? I am not sure that they have done a D-dimer on her and am not familiar with a VQ scan? I hope someone figures something out soon so my sister can have some peace of mind. This is all very upsetting to her and the rest of the family as well. I believe in the specialists she has seen and trust them. I guess this whole process just requires alot of patience which is difficult to have when it's family. Thanks so much for your posts. They are much appreciated!!

 
Reply With Quote
Reply Reply




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 08:34 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!