posted
(These events took place and this thread is from a long time ago. My stepbrother is okay, although not unaffected by the experience. Because of the information and the personal events shared here, I am leaving the thread.)
My stepbrother is in the hospital because of a seizure because of lack of oxygen to the brain because of congestive heart failure because of...they don't know. They don't know why his heart is functioning at 10%. No congenital heart defects, no coronary artery disease, no previous heart attacks, he's 33 years old, doesn't smoke or drink and is not overweight.
My dad suggested that it was a virus that had attacked his heart, or else maybe the medications he was taking had that as a side effect. However, those are the precise reasons my mother had CHF, so I'm not sure if he got that from the doctor or from his previous experience.
Does anyone know where to find an exhaustive list of causes?
WebMD was distinctly unhelpful, but I did find the page on the AHA's site here. In other words, I googled for "causes of congestive heart failure" and read the first page, but I was wondering if there is something else out there.
quote:Finally, in many patients, dilated cardiomyopathy has no clear cause. Possible explanations have included chronic viral myocardial infection, autoimmune mechanisms, and genetic factors that directly contribute to development of the disease.
*hands in the air* I don't know. It falls into this category, as far as I can tell. We don't know about his genetic history - he was adopted as a baby.
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They ought to know by now a bit about what isn't functioning right, even if they don't know why, like if he has valve problems or a small heart or a big heart. Or fluid around the heart. What are they saying? Large, dilated heart?
The list of causes changes based on his echocardiogram results.
Were his heart symptoms sudden or has he had problems for awhile? Any illnesses lately?
posted
No illnesses lately. Family says that he's been kind of slow, though - not actually sick, but exertion was difficult. Apparently his heart was enlarged. They kept him cold - I think they dropped his body temperature so he wouldn't need as much oxygen. I just called the plant, but my dad has gone to the hospital. I think they are warming him up so they can take him in for a CAT scan right now.
From what I read, exertion being difficult is very consistent with CHF. I think...I don't think they knew that he was sick, but I think he's been affected by it for a little while.
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posted
Rheumatic fever usually causes heart failure by impairing valve function, so that isn't all that likely unless there are indeed bad valves present.
Kat, there is a big difference between a large, dilated heart and a large, thick-walled heart. They are different problems associated with different causes of heart failure. If his is dilated then I'd guess it IS a dilated cardiomyopathy and I could email you some information on the causes.
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posted
I was thinking in terms of leaky heart valves leading to over-exercize of heart muscles to keep the oxygenation levels somewhat near normal. With the constant over-exercize leading to heart enlargement. Posts: 8501 | Registered: Jul 2001
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Sure, I'm just saying, if he doesn't have leaky valves, then it probably isn't from rheumatic fever. They would have seen valves that bad on echocardiogram already and I was assuming that there weren't any since Katharina hasn't mentioned it.
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I think the picture we're coming up with is that Congestive Heart Failure is a symptom and not a specific disease. Much like a fever. It's a very scary and serious symptom. (((kat)))
:Stabs google ads: Who buys an L-VAD because of a google ad, for pete's sake?
No heart defects. Heart is dilated, for sure. He had a seizure two years ago, but he came out of it quickly. I don't think they figured out why he had it then. No swelling in legs, no previous symptoms except he told his wife two weeks ago that he felt a little bit light-headed.
They had him on ice so his heart wouldn't have to work as hard, but apparently you can only do that for 24 hours before things like frostbite become a problem. When they warmed him back up, his heart started failing again. The heart's output is 10% of capacity. They doing an ECG this afternoon to find out...I don't know what.
It all leads back to why isn't his heart working, and no one knows at the moment. It isn't ANY of the usual suspects.
On top of everything else, that's downright unsettling.
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Being curious creatures, we like the word "why" a lot. Unfortunately, there sometimes is no better answer than "just because". I'll be praying for you guys, kat.
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No change. That's not promising. My dad thinks he is gone, but I don't know how much of that is the doctors and how much of that is my dad's previous experience.
I found out more information. He has been having regular checkups, and they never found anything. They could have missed something, or there could have been nothing there to find. He's has early arthritis for a long time and sometimes takes pain medicine for it. I wonder if that's it?
Theca and pharmasists - do some pain medications have this as a risk factor? It's just so completely out of nowhere.
He definitely had a seizure, and the doctors said the seizure was caused by a lack of oxygen.
Does anyone know how a lack of oxygen causes seizures? Or, where can I look to read about it?
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Kat, seizures can be caused by any sort of brain damage. Somehow even small damages can sometimes create a situation in which seizures can be easily started/triggered. Strokes, brain hemorrhage, trauma can all cause seizures. In fact, if part of the brain got very little oxygen due to the heart failure, then that would be very similar to certain kinds of strokes where a vessel gets blocked.
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Does that link work? It's a chart of causes of dilated cardiomyapathy including drugs. As you can see there are a lot of things listed but not too many drugs. I never heard of pain meds causing this.
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Arthritis is also a rheumatic fever symptom.
I'm surprised that the doctors aren't talking about implanting a left ventricular heart pump/booster. The percentage of favorable outcomes and the degree of improvement in circulation is rather astonishing. Though less tested, heart reduction surgery also seems to be gaining favor in treating enlarged hearts.
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Not to, ah, rain on anyone's parade, but in the condition he's in, I wouldn't think they are considering surgery now for good reasons. Posts: 21182 | Registered: Sep 2004
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The heart booster/pump was first tested on the most difficult to treat, elderly patients with end-stage congestive heart failure. And they are currently being tested on children as young as six years old: not merely to bridge the time while awaiting transplant but also in hopes that lessening the circulation load will allow the heart to repair itself.
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I agree, there are some simple assist devices that do not involve, say, open heart surgery. Minor surgery. I kind of assumed maybe they were using one already. Or at least considered the pros and cons of it. If they have been resorting to measures such as cooling the body down, etc, then I assume they are using all the resources available that would be indicated in life-threatening failure.
posted
Added a link to my previous posting. I think living with a permanent battery-powered implant for 1815days / 4years&2months -- as of 16August2004, the last report I could easily find on the Web -- is a good outcome for a 67year old who had entered end-stage cardiomyopathy. It was memories of very recently watching an interview with him -- praising the device for allowing him to do things that he hadn't been able to do for many years -- which prompted me to write about it. Peter Houghton also told an amusing anecdote about a snatch&run thief running off with his battery...
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*nods* Thank you for the information. I'm looking at the causes of cardiomyopathy list, and it's quite a list. I guess it could be lots of different things.
The thyroid one was interesting, because my mom had trouble with her thyroid. In fact, my mom had three or four disparate things on that list.
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I'm sorry katharina. They suspect Stephens dilated cardiomyopathy was virus related but said they can never be 100%. I sure hope they figure out what is going on. Its a tough situation for sure.
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"He's has early arthritis for a long time and sometimes takes pain medicine...do some pain medications have this as a risk factor?"
The new COX-2 inhibitors Vioxx and Bextra are implicated in causing heart problems -- they've recently been pulled from the market -- as well as the still available COX-2 Celebrex, and the NSAID naproxen sodium (Aleve) to a less-sure extent.
Since they seem to cause platelet clumping -- which could cause blood clots leading to narrowing of veins and arteries, and blocked capillaries* -- and do cause high blood pressure, it is plausible that the combination of lessened blood flow to heart muscles and high blood pressure from venous and arterial congestion could cause the heart to work harder leading to enlargement.
Aleve was marketed as a drug which could allow longer periods between dosages, ie more convenient for those who used pain relievers for chronic conditions such as arthritis.
Celebrex, then Vioxx and Bextra were marketed as less likely to cause ulcers in chronic users such as arthritis sufferers -- which was pure marketing scam from the start -- than conventional NSAIDs such as aspirin and ibuprofen. Merck is now known to have been deliberately disinforming physicians about Vioxx's possible bad side-effects on the heart. I would be very surprised if the makers of Bextra and Celebrex weren't equally aware, or deliberately chose not to know by carefully designing/limiting their studies so that bad side-effects -- not necessarily to the heart -- were unlikely to appear in clinical trial submissions to the FDA for marketing approval.
* Capillaries are the vessels in which the oxygen and carbon dioxide exchange occurs between the circulatory system and other body tissues. Lessened capillary capacity causes a lessening of ability to make that exchange, causing the tissues served by those capillaries to signal that they have too much carbon dioxide build-up, and hence not enough oxygen. Which in turn causes the heart to pump harder to raise blood pressure to try to force more red blood cells through those capillaries.
posted
*nods* Thank you. That's very informative. Hmm...
I knew I forgot something from earlier - he did not have high blood pressure. Or low blood pressure. Because of the arthritis and back problems, he had regular checkups, so they know his blood pressure was normal.
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Aspectre's suggestions fall under the "ischemic" cause of cardiomyopathy. Very unlikely in someone his age, unless he WAS taking nsaids daily for 2 years or longer. Then it would be slightly more likely. Of course, he could have a terrible family history which would make this chain of events much more likely, but since he was adopted you don't know his family history. No way to tell if his coronary arteries are bad unless they do a cardiac catheterization.
Okay, so that's the same thing that causes most of the strokes we hear about. The cardiac swelling would come from the heart having to work so much harder because blockages in various places would trigger the "more oxygen needed" mechanisms.
To me (FWIW), it seems less likely for two reasons: blood pressure was normal at all previous (frequent) checkups, and there was no swelling. When capilaries get clogged, you get swelling in places, right? Legs, especially? He didn't have that at all before the seizure.
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I'm have having trouble interpreting your post, Kat. Until you know for sure whether he has dilated cardiomyopathy or whether it is some other type of heart failure it is going to be impossible to figure anything out.
Ischemia means lack of oxygen, yes. If the vessels of the heart were narrow for some reason that can cause ischemia which causes death to some heart tissue which can lead to the abnormally shaped, weak heart. I wouldn't say the heart is swollen, though. If his heart is indeed dilated that suggests to me that the wall of the heart is thin from loss of tissue for whatever reason and therefore it balloons out more than normal hearts, if that makes sense. (If it is big but not dilated, that would be hypertrophy of the heart tissue, often causes by the heart having to work too hard for some reason)
I wouldn't say capillaries cause swelling. Swelling in the legs is caused by poor return of blood to the heart. Right now your brother's symptoms are related to the weak heart not pumping arterial blood out and around to the tissues of the body. Many people with heart failure suffer more with problems of the venous blood returning to the heart. That is when you see swelling. Why he isn't having swelling I don't know.
quote:The cardiac swelling would come from the heart having to work so much harder because blockages in various places would trigger the "more oxygen needed" mechanisms.
That isn't the way it works, if my previous post leaves you with questions just let me know. Or email me.
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I've been getting the information from my dad, and he hasn't used medical terms at all. I know that his heart is enlarged, I think it is dilated, and that it is still working, but just far below capacity.
Hhmm...so the swelling thing wouldn't come anyway. Okay.
quote:If the vessels of the heart were narrow for some reason that can cause ischemia which causes death to some heart tissue which can lead to the abnormally shaped, weak heart. I wouldn't say the heart is swollen, though. If his heart is indeed dilated that suggests to me that the wall of the heart is thin from loss of tissue for whatever reason and therefore it balloons out more than normal hearts, if that makes sense.
Yes, that makes perfect sense. You do an ultrasound to figure out if all the heart tissue is still alive, right? I don't know if Ryan's had one, but I remember my mom had one. That's when they figured out that she'd had a virus attack her heart.
Ryan didn't have any swelling before the seizure, but there is swelling now.
Hmm...stil don't know underlying cause, then. I can't keep asking my dad - he keeps giving me the stuff that made my mom sick, and I'm honestly not sure if it's what wrong with Ryan or what was wrong with her.
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I still have a hard time with the concept of people dying from heart problems. Especially younger people.
And my family always gives me the nonmedical descriptions of problems and it drives CRAZY. Especially when their descriptions don't make any medical sense.
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I know what you're going through. I tried to piece together my father's aortic dissection from my mom's unmedical explanations. It just doesn't work and is extremely frustrating leaving you with more questions and what-ifs than answers. *hug*
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kat, when this was happening with my dad, it turned out to be this.
They thought his heart was very enlarged but that wasn't it. He had fluid in the pericardial area so there was no room for his heart to pump. This caused his heartbeat to be very fast and faint. The fluid also showed up on x-rays like an enlarged heart, apparently. Because his heart wasn't pumping well, his lungs couldn't clear, and so they got fluid in them and he wasn't able to breathe well either.
They did a pericardial window (cutting a hole in his pericardial sac? so that the fluid could drain into his abdominal? cavity and be absorbed) and his heart and lungs cleared up totally. It was wonderful to see him breathing deeply and easily for the first time in several months. Unfortunately he never came out of the anaesthesia from that surgery and he died 10 days later.
But all along they had been misdiagnosing his heart and lung problems and I don't think anyone ever really understood their mistake and learned from it.
No idea if this could be the same thing, but I hope it helps someone sometime. You are in my prayers. <<<<<<<<<<<<<hugs>>>>>>>>>>>>>>>>>
quote:They thought his heart was very enlarged but that wasn't it. He had fluid in the pericardial area so there was no room for his heart to pump. This caused his heartbeat to be very fast and faint. The fluid also showed up on x-rays like an enlarged heart, apparently.
Eesh, that'd be no good. A dude could be dying of cardiac tamponade and it shows up on x-ray as an enlarged heart.
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Don't know if this will help at all, but my mother passed away two years ago from CHF-- and while I'm not sure as to the step-by-step degradation, first she got leukemia about a year before that, went into remission, but then got pneumonia because of her damaged immune system.
The pneumonia led to her heart failure-- and then to blood clots popping up in her blood stream. Of course my mother was an extreme case--a hearty little woman who didn't want to give up. It doesn't sound like this really applies to your brother, but I figured I would just lend my experience.
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For those who may not have noticed, this thread originated in May 2005. I don't know what happened with kat's stepbrother, but it is almost certainly not a current issue.
asectre, while I can understand wanting to revive an old thread on a topic instead of starting a new one, the topic of this thread was kat's stepbrother's specific problem, not CHF in general. Resurrecting it like this causes confusion, and could be considered pretty tasteless, depending on what the outcome of kat's stepbrother's heart problems was.
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Fortunately for aspectre, my step-brother is okay. Physically, he's just about fine. However, I think...I think the whole experience shook him up a great deal, as you can imagine, and there's still emotional fallout that his family is dealing with.
I agree with ElJay - you shouldn't have revived this thread, aspectre. It was really tacky, and I think you did it on purpose, knowing how tacky it was. Bad form.
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I was thinking in terms of leaky heart valves leading to over-exercize of heart muscles to keep the oxygenation levels somewhat near normal. With the constant over-exercize leading to heart enlargement. ![[Frown]](frown.gif)
I'll be praying for you guys, kat.
