Heart surgery and TIA, help please
Discussion
My dad had open heart surgery a couple of weeks ago to repair a valve. Since then my mum has had to call an ambulance twice for him when he had transient ischaemic attacks (TIA), otherwise known as a mini-stroke. Both times he's been fine afterwards except for obviously being very upset and freaking out that he's going to die of a heart attack.
He's on Warfarin which the doctor said should mean he wouldn't have the TIAs but this obviously isn't the case. He's also on beta blockers for irregular heartbeat. Today they did the camera down the throat routine to see if the valve repair was still intact as they can't work out what's causing the TIAs and found nothing. Blood tests are also clear. Apart from all this, he says he feels fine, just tired.
Does anyone have any experience or knowledge of this stuff? If so, I'd be grateful for your input as I'm worried sick. Thank you.
He's on Warfarin which the doctor said should mean he wouldn't have the TIAs but this obviously isn't the case. He's also on beta blockers for irregular heartbeat. Today they did the camera down the throat routine to see if the valve repair was still intact as they can't work out what's causing the TIAs and found nothing. Blood tests are also clear. Apart from all this, he says he feels fine, just tired.
Does anyone have any experience or knowledge of this stuff? If so, I'd be grateful for your input as I'm worried sick. Thank you.
Silver said:
My dad had open heart surgery a couple of weeks ago to repair a valve. Since then my mum has had to call an ambulance twice for him when he had transient ischaemic attacks (TIA), otherwise known as a mini-stroke. Both times he's been fine afterwards except for obviously being very upset and freaking out that he's going to die of a heart attack.
He's on Warfarin which the doctor said should mean he wouldn't have the TIAs but this obviously isn't the case. He's also on beta blockers for irregular heartbeat. Today they did the camera down the throat routine to see if the valve repair was still intact as they can't work out what's causing the TIAs and found nothing. Blood tests are also clear. Apart from all this, he says he feels fine, just tired.
Does anyone have any experience or knowledge of this stuff? If so, I'd be grateful for your input as I'm worried sick. Thank you.
Sorry to hear about your Dad's woes. Some info but I'm no expert...He's on Warfarin which the doctor said should mean he wouldn't have the TIAs but this obviously isn't the case. He's also on beta blockers for irregular heartbeat. Today they did the camera down the throat routine to see if the valve repair was still intact as they can't work out what's causing the TIAs and found nothing. Blood tests are also clear. Apart from all this, he says he feels fine, just tired.
Does anyone have any experience or knowledge of this stuff? If so, I'd be grateful for your input as I'm worried sick. Thank you.
TIA's are shortages of oxygen to the brain, blockages in the smaller blood vessels which could be the result of blood clots caused by surgery. Warfarin is a drug which breaks up blood clots, aspirin has a similar effect by thinning the blood.
Good news: Having TIA's doesn't mean he's at risk of a heart attack.
Bad news: Having TIA's means he's at risk of having a stroke.
95% of strokes are blockages, so Warfarin (or Aspirin) are the best treatment. The other 5% are aneurisms, burst blood vessels where warfarin/aspirin are the worst thing possible.
Camera down the throat would be for something totally different, your heart and brain can't be reached that way.
What were his symptoms, and who decided he had a TIA? Are the heart surgeons being consulted, or is this a seperate team (A&E) diagnosing him.
Good luck, stay strong.
-Pete- said:
Sorry to hear about your Dad's woes. Some info but I'm no expert...
TIA's are shortages of oxygen to the brain, blockages in the smaller blood vessels which could be the result of blood clots caused by surgery. Warfarin is a drug which breaks up blood clots, aspirin has a similar effect by thinning the blood.
Good news: Having TIA's doesn't mean he's at risk of a heart attack.
Bad news: Having TIA's means he's at risk of having a stroke.
95% of strokes are blockages, so Warfarin (or Aspirin) are the best treatment. The other 5% are aneurisms, burst blood vessels where warfarin/aspirin are the worst thing possible.
Camera down the throat would be for something totally different, your heart and brain can't be reached that way.
What were his symptoms, and who decided he had a TIA? Are the heart surgeons being consulted, or is this a seperate team (A&E) diagnosing him.
Good luck, stay strong.
Thanks for replying. TIA's are shortages of oxygen to the brain, blockages in the smaller blood vessels which could be the result of blood clots caused by surgery. Warfarin is a drug which breaks up blood clots, aspirin has a similar effect by thinning the blood.
Good news: Having TIA's doesn't mean he's at risk of a heart attack.
Bad news: Having TIA's means he's at risk of having a stroke.
95% of strokes are blockages, so Warfarin (or Aspirin) are the best treatment. The other 5% are aneurisms, burst blood vessels where warfarin/aspirin are the worst thing possible.
Camera down the throat would be for something totally different, your heart and brain can't be reached that way.
What were his symptoms, and who decided he had a TIA? Are the heart surgeons being consulted, or is this a seperate team (A&E) diagnosing him.
Good luck, stay strong.
Re. aspirin, they advised him today to take 1/2 tab every other day along with the Warfarin to help with the blood thinning.
Camera down the throat was apparently to check that something hadn't come loose and made its way to the brain. I forgot to mention that after the op, his vision was off - he said he was 'seeing things', like a table being covered with dust or a path being cobbled when it wasn't. The docs thought that there might be a fragment from the surgery affecting the vision part of the brain, he told me.
His symptoms were loss of feeling down one side of his body, he was diagnosed in A&E (I think) but a heart surgeon did come over from the hospital the first time he was taken in - he was taken to a different A&E than where he had the surgery as he's between two hospitals.
It's difficult because I don't live close to them so am relying on what he and my mum tell me which I don't think is always 100% accurate. Also means I can't dash over easily and have nail-biting waits between text messages and calls from family who are there.
95% of the time, blood thinning is a good thing.
Your next bit "Camera down the throat was apparently to check that something hadn't come loose and made its way to the brain." doesn't make any sense, as I said there's no way to see heart or brain down there. Check with the hospital why they put a camera down his throat.
Disturbed vision could be from a 'fragment' causing a blood shortage in his brain. Warfarin and aspirin should prevent it happening again, don't worry.
"His symptoms were loss of feeling down one side of his body, he was diagnosed in A&E" - that sounds like a TIA, or mini-stroke. Again, 19 times out of 20 warfarin and aspirin, rest and time will sort that out.
You need to be strong for your parents, try not to worry (it doesn't help them or you) and see if you can get more info about the details.
Your next bit "Camera down the throat was apparently to check that something hadn't come loose and made its way to the brain." doesn't make any sense, as I said there's no way to see heart or brain down there. Check with the hospital why they put a camera down his throat.
Disturbed vision could be from a 'fragment' causing a blood shortage in his brain. Warfarin and aspirin should prevent it happening again, don't worry.
"His symptoms were loss of feeling down one side of his body, he was diagnosed in A&E" - that sounds like a TIA, or mini-stroke. Again, 19 times out of 20 warfarin and aspirin, rest and time will sort that out.
You need to be strong for your parents, try not to worry (it doesn't help them or you) and see if you can get more info about the details.
Silver said:
My dad had open heart surgery a couple of weeks ago to repair a valve.
Diseased valves (probably the aortic valve) and AF (Atrial Fibrillation) can cause CVAs (strokes) or TIAs (mini strokes).Your heart is two pumps in one. Each side has two chambers. The right side pumps blood to the lungs to be oxygenated which then returns to the left side of the heart which then pumps the blood to the rest of the body (and then back to the right side of the heart).
AF is when the top part of the heart beats much too quickly, instead of 60-100 minute (typically). This can cause the blood to "pool" in the heart, and a diseased valve can cause the blood to "swirl". The upshot is, pooling and swirling can cause small clots to form in the heart. These are then pumped around the body, and may find their way to the brain, causing a blockage, which leads to a stroke, which is a TIA if symptoms persist for <24 hours or CVA if >24 hours.
Hope your dad is feeling better. How old is he, does he smoke and does he have a family history of CVA/TIA?
JumboBeef said:
Hope your dad is feeling better. How old is he, does he smoke and does he have a family history of CVA/TIA?
He's 73, doesn't smoke and hasn't for about 50 years. As far as I know there's no family history of CVA/TIA.Spoke to him last night, he says he feels fine and he sounds in fairly good spirits so fingers crossed.
-Pete- said:
Your next bit "Camera down the throat was apparently to check that something hadn't come loose and made its way to the brain." doesn't make any sense, as I said there's no way to see heart or brain down there. Check with the hospital why they put a camera down his throat.
It sounds more like a Transesophageal echocardiogram, I think that's the correct name, my brother has had a couple done. I doubt the OP is getting 100% of the right info from his mum.TOE sounds correct - was nursing in cardiothoracic surgery from 1989 - 1991 (makes me feel rather old!). Is there is a possibility it may be related to post-perfusion syndrome? http://en.wikipedia.org/wiki/Postperfusion_syndrom...
SD.
SD.
Thanks to everyone who's replied. I'm grateful for the helpful and supportive response this has had.
He seems much more settled now. There have been no more TIAs and although the doctors are at a loss to explain why they occurred in the first place, they're keeping a close eye on him and he's having blood tests every couple of days. He had to come off his Warfarin for a couple of days as he had a stomach bug and wasn't eating or drinking enough but is otherwise recovering.
I went up there last weekend and he seemed tired but generally in good spirits. I think it was a bit of an emotional time for everyone, especially him.
Fingers crossed.
He seems much more settled now. There have been no more TIAs and although the doctors are at a loss to explain why they occurred in the first place, they're keeping a close eye on him and he's having blood tests every couple of days. He had to come off his Warfarin for a couple of days as he had a stomach bug and wasn't eating or drinking enough but is otherwise recovering.
I went up there last weekend and he seemed tired but generally in good spirits. I think it was a bit of an emotional time for everyone, especially him.
Fingers crossed.
Post perfusion syndrome = "pumphead". Less of an issue now as we don't use bubble oxygenators in the bypass circuits. Usually occurs in the first few days post bypass.
Camera down throat is probably a transoesophageal echo. You get much better image quality than transthoracic echo and allows you to visualise more of the left atrium. TOE is usually done at time of operation so repeats can compare images of the valve functioning when it was brand new and the heart was being restarted coming off bypass. Also, only ToE can look at the left atrial appendage which is a common place for blood clots to form. Bits of the clot break off and cause TIAs.
Hope the TIAs settle down! Good luck!
Edited to add: he would have had carotid Dopplers to look for stenosis as part of the work up for surgery.
Camera down throat is probably a transoesophageal echo. You get much better image quality than transthoracic echo and allows you to visualise more of the left atrium. TOE is usually done at time of operation so repeats can compare images of the valve functioning when it was brand new and the heart was being restarted coming off bypass. Also, only ToE can look at the left atrial appendage which is a common place for blood clots to form. Bits of the clot break off and cause TIAs.
Hope the TIAs settle down! Good luck!
Edited to add: he would have had carotid Dopplers to look for stenosis as part of the work up for surgery.
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