Your Questions Answered
"I have had congenital AV block since I was born my sister has the same but now has a pacemaker. My pulse is around 44 but causes no symptoms as has always been like this. I am in wheelchair due to Cerebral Palsy which only effects my legs. Have had two TIA 5 years in between each last one 2014. No blood clots were found with either . Had a Takotsubo Cardiomyopathy in November 2014 recovered well . I have hypertension which I have now been prescribed AMLODPINE is this medication okay to take with my heart condition I was on Candersatan 2mg ."Zanney, Support Network Member
"I would follow your cardiologist’s recommendations. Both medications are frequently prescribed by cardiologists, but the person who has access to all of your medical records can best determine the proper medications for your health conditions. On the surface, I do not see a specific problem with your medication regimen.Dr. John Breinholt, Pediatric Cardiology
Thank you, Dr. John Breinholt"
"My son had a heart attack last Friday. Fout stents put in. He is a vegetarian and i would like to know what kind of diet should he be on."FOXMOM, Support Network Member
"Vegetarian diets can be healthful and nutritionally sound that your son can carefully plan to include essential nutrients. A diet with too many calories and/or saturated fats and not enough important nutrients can be unhealthy. Plant proteins alone can provide enough of the essential and nonessential amino acids and caloric intake to meet energy needs. For iron, dried beans, spinach, enriched products, brewer’s yeast and dried fruit, any type of vegetarian diet should include a wide variety of foods and enough calories to meet the individual energy needs.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I was told I have an enlarged heart what exactly does that mean"MAKB32, Support Network Member
"An enlarged heart is medically known as cardiomegaly. This condition can be caused by a number of different conditions such as high blood pressure or coronary heart disease. The condition Cardiomegaly is referring to the damage of the heart and each individual case is different such as with treatments.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I had triple bypass in Nov. Now 2 of the bypasses have closed up an my cardiologist wants to do 4 stints (in the original arteries). Is this normal?"fuchsiatwill, Support Network Member
"Each individual’s history and condition is different There are other factors that would help determine the decision that was made by your cardiologist. It is recommended that you speak with your cardiologist to determine if this procedure is common for your condition and why.Dr. Latonya Law, Family Nurse Practitioner
Dr. Latonya Law"
"My son diagnosed HCM with Non Obstructive type in June 2017 when he was 7 years old. His Septum is 13mm when he was diagnosed. The last screen he had in December 2017 indicates there is no change for the thickness. We did gene test for our other children, and just found out his siblings (6 years old boy and 1 year girl) have the same HCM mutation as their brother. But they don't have the symptom and clear from HCM for now. This is such a shock news for myself and my husband. I did the gene test last week to find out if I am the carrier. Andrew’s cardiologist said either me or my husband would be the carrier. The good news is both of us are asymptomatic and no family history of sudden cardiac arrest at an earlier age either my husband or my side of family. This disease's prognoses uncertainty is my big fear."lindi492, Support Network Member
"The most important thing to do at this time is establish a relationship with a cardiologist for all gene affected family members. They will require lifelong follow-up, to be able to identify changes, if any, at an early stage. It is the best way to counter the uncertainty. The cardiologist should be one that specializes in cardiomyopathies, and even better, if they specialize in cardiac genetics. These people are out there and have the knowledge and experience to help them and inform them.Dr. John Breinholt, Pediatric Cardiology
Thank you, Dr. John Breinholt"
"I have had heart surgery (2014) to replace my mitral valve and am on blood thinner. Out of the blue last year I had a stroke. I am seeing a nutritionist to help keep my vitamin K levels more level. She seems to care more about weight loss and not enough about my vitamin k consistency. How can I find someone who can help me with that? I do not want another stroke nor mess up my nice shiny heart valve."athenatoo, Support Network Member
"If you are a heart patient who is taking blood thinners, such as warfarin (Coumadin®), you need to be careful not to overdo vitamin K. Blood thinners are often prescribed for people at risk for developing harmful blood clots. If you suddenly increase your intake of vitamin K intake in your diet, it can have an unintended consequence and can actually decrease the effect of warfarin. If you are on Coumadin (Warfarin) it is important to monitor your International normalized ratio (INR). You should discuss with your primary doctor what level your INR should be with your new valves. The dietician can inform you on what foods are high in Vit K that could decrease the effect of the blood thinner. Vit K does not prevent a stroke or lead to a stroke but it effects the blood thinner. The dietician is also concerned with weight because increased weight is another risk factor of having another stroke.Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"
"We are currently in UCSF Benioff Children's Hospital after our daughter -12 years old suffered a Ischemic stroke during catheterization to ascertain her heart valve condition. She has lost the ability of speech and language (Aphasia). Her right hand is getting toned and her right feet toes are getting curled. She underwent open heart surgery 6 weeks after the stroke and is recovering from it. We are quite worried that after a few days when we go home (becaue her heart condition is getting better), her daily therapies (OT, PT and Speech) will be limited to 2-3 times a week. She has been a brilliant child in her middle school and we want to bring her back to her condition that she was in before the stroke. How can we help her? How do we find best therapists and resources in SF Bay Area who can help her?"Saloni, Support Network Member
"I am sorry to hear about Saloni’s stroke, but she seems to have a strong willpower and a very supportive family! There will be several doctors on her team as she continues to recover. Due to her cardiac condition, it will be important to make sure that her Cardiologist is in agreement with the rehabilitation process. I would recommend reaching out to her neurologist and possibly having a PMR ( Physical Medicine and Rehabilitation) doctor who can help guide with best outpatient and inpatient options for therapies based on her medical condition, especially from a cardiac standpoint.Dr. Nivedita Thakur, Pediatric Neurologist
Thank you Dr. Nivedita Thakur"
"My mother passed away 5 weeks ago and I am still feeling this tremendous guilt that I could have done something to save her. My mom was 74 and had a history of high blood pressure. She suffered a massive stroke of 50 percent of her brain (right side) & the swelling was so much that they had to perform cranial surgery early the next morning to remove a piece of her skull. Unfortunately, she was on the floor for 5 hours until her boyfriend found her. She survived the brain surgery and was in vegetative state for a few days. She was able to breath on her own. She slowly began to speak and really understand and responded in short phases. Her whole left side was completely paralyzed including her neck , throat and left eye. Biggest problem was Dysphagia, she was not able to swallow. She had severe Dysphagia and I was constantly using a tube to clean out all the mucus from her throat. Her pulomologist (main doctors) in the ICU told me that she would probably never eat again (PEG for life) and she would be severely disabled and in bed for life. Peg & tract surgery . The doctors said she was not rehab able and no one would accept her but a nursing facility. My mother had a very detailed living will. She Said NO TUBES of any kind. Since she was able to talk and communicate, I had the doctors asked her around 20 times to take the feeding tube. But her answer every time was no. I needed to feed my mother, so I put her on TPN for 8 days in the ICU hoping she would change her mind about the Tube Feeding. I just felt that maybe doctors were wrong and that since she was talking she would eventually learn with therapy to eat thicken foods & thicken liquids. Maybe PEG just for a few months until she learns how to swallow on her on. All doctors in ICU Said she need to be transferred to hospice . I am Sent all the scans to the head doctors of University of Miami , and again doctors response was Hospice. Everyone doctor concluded That my mother would have a very poor quality of life and with PEG feeding most likely would cause her to have pneumonia and have a torture passing . They gave her 6 months the most , but most of the doctors really thought 1 month. She was soon transferred to Hospice and my nightmare became a reality. I was going to lose my mother. I just lost my father 5 weeks prior to dementia. So losing my mother was another loss so quickly. As soon as she went into hospice I felt she was getting better. The mucus wasn’t building up in her lungs anymore and she was more alert then ever. Doctor said since she was no longer on IV the fluids the build up went away. My mother was getting better and better but was starving to death. I gave her ice chips and still pleaded with her to Take the feeding tube. Soon I begged the hospice staff to prove to me that my mother couldn’t eat. The nurses and doctors all came to her bed side and giving her a little apple sauce (a drop) on a spoon. She couldn’t even swallow the tiny bit. Then the following day they tried again, but she still couldn’t and was coughing . The hardest thing was that my mother was able to communicate small phrases & actually looked beautiful at the end . My mom soon went through the dying phases and passed aways 2 weeks later in hospice in my arms. I feel like if I just persuaded her to take the PEG feeing tube she could have survived ??"Almagor, Support Network Member
"I’m so sorry for the losses of both of your parents in quick succession. I would imagine that you are still reeling. There is small solace here that you should not lose sight of: Unlike your father, your mother was able to understand what was going on and to relate to you cogently until the end. You should also take comfort in knowing that she made her own decision about dying. It was not a decision with which you agreed but it was one about which she was consistent and firm. I applaud you for respecting and loving her enough to honor her right to make that choice, even as it resulted in her leaving you. Please know that you were a very good son to her. I doubt there was more you could have done to change this unfortunate course. Helping yourself ultimately heal from these losses will require avoiding too much guilt. I’m sure your mother would not have wanted you to beat yourself up after she was gone.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I have almost constant dizziness. Is this due to my meds? my former stroke? what?"Billybubb27, Support Network Member
"That is a difficult question to answer – dizziness can be caused by medications and by a stroke, not knowing where your prior stroke or what medications you are on makes this difficult to answer. You should consult your primary caregiver to discuss the possible cause of your dizziness Thank you, Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
"Hello A recent carotid ultrasound indicated that my left carotid was 60-80% blocked. My cardiologist said that they don't consider putting in a stent until it is more than 80% blocked and there are symptoms such as dizziness. But I am concerned. Isn't there an elevated risk of an ischemic stroke caused by a smaller blood clot being able to block my left carotid? Should I seek to have stent put in right away? I am 73 years old. Also, last April I fainted, and went into intensive care and rehab. My cardiologist said it was due to low blood pressure and dehydration. Could my left carotid condition have contributed to the low blood pressure? Also, could my left carotid blockage be already affecting my brain and my mental abilities? My cardiologist took an electrocardiogram, and doesn't seem too concerned about my heart, even though I have mild aortic valve stenosis. Am I being too alarmist? Thanks."tahilg, Support Network Member
"There are national guidelines that are recommended for symptomatic patients who have more than 50% stenosis or asymptomatic patients who have more than 70% stenosis. If you have been asymptomatic (no symptoms) then it would be normal not to have a stent inserted at this time. You may not have any symptoms of carotid artery disease. Plaque builds up in the carotid arteries over time with no warning signs until you have a transient ischemic attack (TIA) or a stroke.Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
Signs of a stroke may include:
Sudden loss of vision, blurred vision, or difficulty in seeing out of one or both eyes
Weakness, tingling, or numbness on one side of the face, one side of the body, or in one arm or leg
Sudden difficulty in walking, loss of balance, lack of coordination
Sudden dizziness and/or confusion
Difficulty speaking (called aphasia)
Sudden severe headache
Problems with memory
Difficulty swallowing (called dysphagia)
It is less likely that the carotid artery would lead to low pressure and it sounds more like low blood pressure and dehydration. Be watchful of the signs above and call 911 and go to the closest emergency room. Aortic valve stenosis ranges from mild to severe. Aortic valve stenosis signs and symptoms generally develop when narrowing of the valve is severe. Some people with aortic valve stenosis may not experience symptoms for many years. Signs and symptoms of aortic valve stenosis may include:
Abnormal heart sound (heart murmur) heard through a stethoscope
Chest pain (angina) or tightness with activity
Feeling faint or dizzy or fainting with activity
Shortness of breath, especially when you have been active
Fatigue, especially during times of increased activity
Heart palpitations — sensations of a rapid, fluttering heartbeat
The heart-weakening effects of aortic valve stenosis may lead to heart failure. Heart failure signs and symptoms include fatigue, shortness of breath, and swollen ankles and feet.
If you have these symptoms let your cardiologist know.
Thank you, Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"
"I was diagnosed with heart failure at only 39. Had angiogram, no blockages, they determined it was " idiopathic etiology " my ef was 35, with in 4 weeks out of hospital and meds. Im back to normal function wise. Is this normal that fast? My last ecg stated " left atrial enlargment borderline" thats it.. i hope this can be a good sign.. thanks"Dough28, Support Network Member
"Idiopathic Heart failure means there is no identifiable cause in which is very common. It could be many etiologies for your symptoms in which you report has resolved. Your cardiologist will continue to monitor you and your progress.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"Can my cholesterol go away???"twinpita, Support Network Member
"Cholesterol is a vital substance in your body in which it does help with the formation of your memories and vital for neurological but when your levels become abnormal it could predispose you to heart disease. You could lower your cholesterol through dietary and lifestyle changes alone. You would want to consult with your PCP to coordinate this change and to be monitored for several months to see what is ideal for you.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I will be 52 this year when I was in my early 30's I was told by my new PCP that I had a heart murmur. After having an Echo done she said it was an innocent murmur and nothing to worry about. But every time I have dental work done I'm given antibiotics as a precaution even though my PCP said it was unnecessary. I have recently been referred to a vascular surgeon and then to a cardiologist due to serve swelling in my legs. The vascular surgeon did a Doppler study of my veins and said it's something that is between my heart and lungs and he referred me to the cardiologist who did an Echo and said my murmur was not so innocent and was a big part of the reason I'm always tired and have a hard time remembering things something. My question is how does a murmur just suddenly show up, and how does a murmur go from "innocent" to "not so innocent" or did whom ever read the echo for my PCP 20 + years ago get it wrong? I know my different diagnoses and medications probably complicate things. Including the diagnosis of fibromyalgia after being in the room with the Rheumatologist for our initial consultation, 10 minutes, and he had it figured out and dismissed what other doctors had diagnosed me with including type 2 diabetes and spondylolysthesis."GSUgal1988, Support Network Member
"Murmurs caused by valve problems or congenital heart problems usually last throughout life, and in some cases, they can worsen over time. Murmurs can occur in a normal heart it happens when blood flows faster through the heart such as when you’re anxious, running a fever of exercising in which an innocent murmur does not cause any symptoms. In the event that symptoms occur when the heart murmur significantly interferes with the heart’s ability to pump blood could be related to many conditions. It is recommended that you follow up with your provider for more information such as for further testing to determine cause and treatment because each case can vary. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"I'm not entirely sure what to log this under, but, I've been diagnosed with Autonomic Neuropathy (non-diabetic). I was diagnosed at 31, have had multiple arrhythmias, and feel at a loss because I am unable to find doctors who are very knowledgeable in this area. Why do you think it's so difficult to find a Cardiologist who is well versed in this, especially since autonomic things so affect the heart/blood pressure?"tmilburn9, Support Network Member
"Autonomic neuropathies are a collection of syndromes and diseases affecting the autonomic neurons, either parasympathetic or sympathetic, or both. This may be why you are having such a difficult time finding a specialist.Kimaka Bowens, MSN, APRN, FNP-C,
The autonomic nervous system modulates numerous body functions; therefore, autonomic dysfunction may manifest with numerous clinical phenotypes and various laboratory and neurophysiologic abnormalities.
Thank you, Kimaka Bowens, MSN, APRN, FNP-C"
"I have Diabetes and now have Diastolic Dysfunction. Is that a condition before heart failure or is it heart failure?"PKSevers, Support Network Member
"Diastolic dysfunction is when the diastole part of the heart is functioning abnormally. The ventricles do not properly relax and become stiff meaning they are not able to fill with blood. This leads to extra pressure and fluid building up in the vessels of the lungs also known as pulmonary congestion or systemic congestion. Diastolic dysfunction is Heart Failure with preserved ejection fraction.Dr. Latonya Law, Family Nurse Practitioner
Thank you for this great question,
Dr. Latonya Law"
"My child has Ostium Secundum ASD of 7-8 mm and Large Perimembranous VSD during his first month of age. Now he is 5 months old and the ASD is 5 mm and Moderate VSD. Can you please suggest wheather any surgery will be needed or it will cure itself."parijat, Support Network Member
"Perimembranous VSDs do not frequently close on their own, particularly if they are moderate to large in size. ASDs can get smaller, and even close. If the ASD is only 5mm at 5 months of age, it is possible it will close, or at least not require surgery (or even catheter based closure). The VSD is more difficult to predict. If the child continues to do well clinically, doesn’t require any medical therapy, is growing and thriving, he can wait. We do watch the aortic valve closely because flow through the defect can influence that valve and cause problems. If it does, surgery will be necessary. Sometimes the defect can be partially closed by valve tissue from the tricuspid valve (from the right ventricle). If that happens (or has already happened), sometimes we can close those defects in the catheterization laboratory, without surgery.Dr. John Breinholt, Pediatric Cardiology
The short answer is the ASD may not need anything or could be closed with a device and without surgery. The VSD is more difficult to predict and hard for me to comment without more information. However, if he is doing well, there is time and surgery may not be necessary.
Thank you for this question.
Dr, John Breinholt"
"I had to list the above option, altho I am not sure it is what I have. What I have is a heart valve defect, since birth, but I only found out about it last year. My lower valve does not completely close, so there is regurgitation, i.e., back-flow in that section of my heart, with every beat. It sounds like a small heart murmur via a stethoscope, but only when I am stressed or troubled. My question is what will happen if I ever have a heart attack? I see physicians at my local university campus. I overheard once that my condition should not pose a problem unless I have a heart attack. What problems would present themselves if I ever do have a heart attack? I work on keeping lower cholesterol, but I inherited it from my Mother, and she always took a statin. I am on one but I know it will make no difference, as I have been on them before. What would happen if I did have a heart attack in relation to my valve deformity?"Annie6556, Support Network Member
"Annie 6556 due to the nature of your diagnosis and defect since birth is highly recommended that you discuss these questions with your cardiologist because they will have your health records available. Each case is different and I would want for you to receive the correct information and what pertains specifically for you.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"Any advice on how to both prepare my 3 year old and myself for her open heart surgery?"MK2018, Support Network Member
"I think the best way to help such a young child is for them to see your love and confidence that everything is going to be okay. They will be scared, and it will be difficult to calm that other than to emphasize the good that is going to come from the surgery.Dr. John Breinholt, Pediatric Cardiology
Make sure the surgeon answers all of your questions to your satisfaction. There is no way for you not to be nervous, and for that reason, they should be dedicated to making sure you know everything you need to be comfortable. Do not believe for a minute that there is a “dumb question.” There aren’t.
Best, Dr. John Breinholt"
"I have ventricular septal defect and tetralogy of fallot i'm 20 years old and starting to think of my future and wondering if i will be able to have children of my own? What might be some risk?"AlyssMitch, Support Network Member
"A healthy patient with a history of TOF can often have children of their own. There can be some risks depending on the heart function, the pulmonary valve function, etc., but probably not sufficient to recommend against pregnancy. The most important thing is that this patient should be seen by an adult congenital heart specialist who can assess them and counsel them on this.Dr. John Breinholt, Pediatric Cardiology
Thank you, Dr. Breinholt"
"My 14 yo daughter was diagnosed four yrs ago with svt and mild leaky tricuspid valve. She had successful ablation three yrs ago. Back then dr said leak would be to be fixed “one day”. But last year it started leaking more. Just had first mri. Says moderate stage. TR 26%. Question of small hole. And borderline rv overload with rv volume 1.5 times that of left. What do you think next set should be? Cardiac Cath? At this rate when would you guess it would need repair? Is it always done open heart? Thanks from a nerve racked Mom!"HollyAlfred, Support Network Member
"Hopefully, you have a pediatric cardiologist who can help guide you in thinking this through and decision making. A cardiac catheterization is probably not necessary at this point, but the valve may reach a point where repair is necessary. From the information provided, I’m not sure if your child has arrived at that point yet. At this point, the primary option for tricuspid valve repair is surgical. Please follow up with her cardiologist and keep asking questions. Thank you, Dr. Breinholt"Dr. John Breinholt, Pediatric Cardiology
"Hello, After a few months after being released from the hospital and being on Coumaden 2.5 MG Tab (1 @ bedtime); Thursday 2- 5 mg, Lisinopril 5 MG Tab ( 1 tab @ day), Metropolol Succina 100 MG ER Tab, and Furosenide 10 MG Tab, I've noticed I have coffee spasms in the middle of the night and during my waking hours. What is the best cure?"cskysurfer, Support Network Member
"It would be important to discuss the calf spasms with your primary caregiver. The spasms could be due to an electrolyte imbalance from the furosemide. LASIX® (furosemide) is a potent diuretic which can lead to a profound diuresis with water and electrolyte depletion. Discuss the cramps first with your primary caregiver they may want to draw lab to take a look at your electrolytes. Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
"4 years postop cryoablation. AF is stable now. What are chances for recurrence?"rayfaymd, Support Network Member
"There are health conditions which tend to cause A-Fib to recur including hypertension, obesity, sleep apnea, diabetes, smoking and binge drinking. Controlling these conditions will reduce the risk of recurrence. Around 50% of A-Fib patients have no apparent pre-existing medical condition—called “lone A-Fib” because there’s no other contributing health condition. After a successful catheter ablation, those with lone a-fib are less likely to have a recurrence. But some lone A-Fib patients do have recurrences. (Some studies estimate a 7% chance of recurrence out to five years, though most recurrences occur in the first six to 12 months.)Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
So why the recurrence for lone a-fib patients? Heart tissue is very tough and tends to heal itself after an ablation. Or, there may be gaps in the ablation lines and the spots may require a touch-up ablation (usually with a much shorter procedure time and easier to perform than the first ablation).
Ask a nurse or technician at your primary care givers office to teach you how to take your pulse to monitor for irregular heartbeat. Be aware of these atrial fibrillation symptoms such as:
Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest.
Reduced ability to exercise.
Shortness of breath.
Thank you, Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"
"After you have a pacemaker put in do you have to be put on a blood thiner"Peaboy4321, Support Network Member
"Unless you're otherwise a stroke risk or have additional problems that compound your heart problems, simply having a pacemaker is not a reason to need blood thinners. The pacemaker is used to treat abnormalities of the electrical conduction of your heart. There may be other cardiac abnormalities such as an irregular heartbeat (atrial fibrillation) that would require to be put on blood thinners. Discuss with your primary caregiver what risks you have for stroke. Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA"Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
"How do I lower my high blood pressure?"Ralph1955, Support Network Member
"The American Heart Association web site has wonderful education on Understanding Blood Pressure and Changes you can make to manager high blood pressure.Debbie Summers, MSN, AHCNS-BC, CNRN, SCRN, FAHA, Clinical Nurse Specialist Acute Stroke Care
These two links will be very helpful to you
Thank you for this great question. Debbie Summers MSN, AHCNS-BC, CNRN, SCRN, FAHA"
"I had a stent placed 8 days ago and also had a blood transfusion i keep feeling overheated is that normal"black1821, Support Network Member
"Good morning Black1821- the symptoms you’re reporting of overheating after stent placement and blood transfusion should be discussed further with your medical provider. With more assessment, your provider will determine if the symptoms you’re having is related to your procedures or other medical conditions. It should also be determined if the symptoms you’re describing is overheating versus flushing which should definitely be monitored. With stent placement, there are many risks and require extensive monitoring with follow-ups. Thank you for asking, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"My wife had a Thalamus Stroke in late January of this year. I have been dealing with her depression, anger and overall lack of motivation. She gets angry over everything that doesn't go right. Turns things into a crisis. Has panic attacks when we are away from home for awhile. Takes out her anger on me for trying to help but moments later will ask for help to do something. How can I deal with the mental issues?"Chris44641, Support Network Member
"Damage to the thalamus--the brain’s hub or relay station for neuronal signals--can cause a wide range of symptoms, including significant mood swings. I recommend asking your wife’s physician to refer her to a neuropsychiatrist (a physician who is double-boarded in neurology and psychiatry and specializes in the behavioral problems stemming from neurological changes) or a psychiatrist with extensive experience working with stroke survivors. A savvy specialist may prescribe antidepressants or other medications for her which may decrease her moodiness and make her much easier to live with.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"Hi - my husband had a "brain stem" stroke 3 years ago. Prior to that, he was a calm man & not easily mad or irritable. About 8-9 months after the stroke, he began to get verbally abusive & it continues to get worse by the day. I never know who, or what, I'm going to see which personality he will be that day. I have depression & anxiety issues that I'm taking meds for, however, his behavior is making it worse for me & thereby increasing his anger/frustration. I really can't stand to be in the same room w/him, & when I am, he frequently spews some verbal tirade. I've tried to talk to his Dr., who put him on an anti-depressant which did no good. His Neurologist gave him a different med in hopes of reducing these episodes. It also is doing no good. I don't know what to do anymore & really really don't want to be around him at all. Can you offer me some idea or info that might help us both? His memory has been significantly affected as well, & I'm concerned he may be in the early stage of Alzhimers (sp?). Thank you for your time & attention, it is much appreciated. Barbara"Barbara55, Support Network Member
"Dear Barbara—It sounds like you are trying your best to help your husband and being thwarted in the process. Do his doctors think that his stroke has changed his personality? (That isn’t generally the case with brainstem strokes.) If so, then you may have to adapt to having a spouse whose moods vary and who has less control over his emotions. If not, then it is likely that he is feeling very frustrated by his physical limitations (often, with brainstem strokes, ataxia or lack of coordination of movements) and then taking those frustrations out of on you. Medications don’t seem to be decreasing his frustrations enough to allow him to treat you with the respect that you are due. I suggest then that you ask his primary care provider for a referral to a marital therapist who has experience working with couples dealing with stroke. That therapist may identify patterns of interaction between you which may be leading him to be verbally abusive toward you. She or he may recommend specific ways that you can change those patterns and consequently have a more harmonious relationship with him. At the same time, please consider reaching out to others for increased support for yourself. A caregiver support group may be immensely helpful.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"How long does it normally take to get over a stroke?"basedin99, Support Network Member
"Recovery from stroke depends on many different factors: where in the brain the stroke occurred, how much of the brain was affected, the patient’s motivation, caregiver support, the quantity and quality of rehabilitation, and how healthy the survivor was before the stroke. Because every stroke and stroke survivor is unique, it is difficult to determine.Kimaka Bowens, MSN, APRN, FNP-C,
With recovery, gains can happen quickly or over time. The most rapid recovery usually occurs during the first three to four months after a stroke, but some stroke survivors continue to recover well into the first and second-year post-stroke.
The above response offers information for recovery. A person with stroke history will continue to be at risk for future strokes unless underlying cause and mechanisms are identified.
Thank you, Kimaka Bowens, MSN, APRN, FNP-C"
"How to get give my heart patient motivation the eat better.?"Jumprope, Support Network Member
"For motivation with eating healthier for your patient you would want to find out their favorite foods or what they prefer. Change is an important part of living with heart disease or trying to prevent so education is the key with the start of motivation plus finding out how you can build on what the patient already prefers. Small changes are important so explain to your patient that changes could occur in increments such as eating one extra fruit or vegetable a day, making breakfast count but adding foods like oats, bran flakes or whole-wheat toast, adding a handful of nuts, cutting out just one sugar-sweetened soda or calorie-laden latte. Give the patient options can be a motivation. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"My husband has chf for 15 years. He is 67 and now we are having problems with his ammonia levels being to high. Blood pressure today was 84/54. Everything now is starting to go down hill. Creating levels (dialysis) which I think he is to weak to even start this. Now the ammonia level with taking generlsc is not working. No one is saying to us that nothing else can be done. Not sure what to do. Very heartbreaking seeing Jim slip away. Does anyone one else have high ammonia levels due to chf thanks"dgiama01, Support Network Member
"Liver dysfunction is commonly seen in patients with heart failure and is a growing public health concern. The dysfunction is caused by the complex vascular system of the liver and its high metabolic activity render it to be vulnerable to different circulation disturbances. This diagnosis can be very complex and you should discuss with your doctor further regarding high ammonia levels because it is very important for physicians and cardiologists to know about the functioning of the liver in patients with heart failure and its impact on the whole body.Dr. Latonya Law, Family Nurse Practitioner
Thank you for this question and conversation."
"Are heart disease and stroke related to each other? If my child has heart disease, could she have a stroke?"AHA/ASA Katie Bahn, Support Network Member
"In adults, high blood pressure, irregular heartbeat, hardening of the arteries, and diabetes can play key roles in stroke. However, this is less common in children. Children can have cardiac issues like congenital heart defects or acquired heart disease that can increase the risk of strokes. It is important for families to discuss the underlying cardiac condition and the risk of stroke with their physician.Dr. Nivedita Thakur, Pediatric Neurologist
Dr. Nivedita Thakure"
"Do children have the same stroke symptoms as adults?"AHAASAKatie, Support Network Member
"Strokes in children, especially infants and newborns, can present differently than in adults. The symptoms could be misdiagnosed with more common conditions that mimic a stroke like viral illness, migraines, or epilepsy.Dr. Nivedita Thakur, Pediatric Neurologist
-Change in mental status--Example: extreme sleepiness
-Using one side of the body more than the other
-Focal signs like weakness
-Change in mental status
-Sudden difficulty with speaking or comprehension
-Sudden vision problems
Should your child experience these symptoms, call 9-1-1 immediately."
"My baby had a stroke in utero. What are the main developmental achievements that I should look for as he grows?"AHA/ASA Katie Bahn, Support Network Member
"Monitoring development will be important, especially milestones that a baby should achieve by a certain age.Dr. Nivedita Thakur, Pediatric Neurologist
Development can be impacted by areas damaged in the brain. Thus the location and extent of injury are important factors. Another important aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or an undamaged area in the same location can take over function. Therefore it is difficult to predict exactly how much difficulty a child will have in the future.
It’s important to follow development closely and get them in therapy to help practice skills they may be struggling with. This will allow the brain to use the pattern of repetition to build pathways that may have been disturbed due to the injury.
Thank you, Dr. Nivedita Thakur"
"What Causes a Pediatric Strokes in children?"AHA/ASA Katie Bahn, Support Network Member
"Strokes in children can be caused by a variety of factors:Dr. Nivedita Thakur, Pediatric Neurologist
Cardiac: Examples--Congenital heart defects or Acquired heart disease
Hematologic: Examples--Sickle cell disease or Clotting disorders
Infection: Examples--Meningitis or Encephalitis
Vascular: Examples--AVM malformation or Moyamoya
Metabolic or Genetic: Examples--Marfan syndrome or MELAS (Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes)
Trauma: Example--head and neck trauma"
"Hi all. My son had a stroke in utero or at birth... he presented with seizures during the first 36 hours of life which were controlled with phenobarbital. He's 7 months now and is doing as great as we could all hope for. Meeting his milestones and more and has no deficits or signs of stroke as of yet. We know that prognosis for this is extremely variable, which is why I'd like to hear if anyone has a similar case/ experience and what the outcome was (in regards to the area of the brain that was affected). His stroke was in his left frontal lobe, I'd say maybe 1/8th of his left side and a small part of white matter in the back of his right side... the neurologist said he is almost borderzone if that helps... I've looked at studies and patients classified as borderzone seemed to have good prognosis... but the studies are all over the map and I don't really know what to conclude at this point other than expect the worst but hope for the best. Any information from patients or parents of children with similar diagnosis would help tremendously."Support Network Member
"Thank you so much for this question. You are correct in the information you have received so far. There are 2 key aspects that we consider. The first is the location and extent of injury. The second aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or undamaged area in the same location can take over function. Thus it is difficult to predict exactly how much difficulty a child will have in the future. Key aspect is following development closely and getting them in therapy to help practice skills they may be struggling with, so that the brain can use the pattern of repetition to build pathways that may have been disturbed due to the injury. I hope this helps you with what to expect in the future."Dr. Nivedita Thakur, Pediatric Neurologist
"how long will I be upset about my grandpa who just died of a heart attack."fjoshua, Support Network Member
"I’m so sorry for your loss. Your grandpa sounds like he meant--and still means-- a great deal to you. Most people underestimate how long they are likely to grieve the death of a closed loved one. In my clinical experience, it is not unusual for someone to suffer significant grief for 1 to 2 years after the death. That’s probably a lot longer than you are hoping for. In general, the intensity of the sadness tends to gradually decrease over time. Even after 2 years, I expect that you will continue to miss your grandpa and feel sad about his absence but you may also be better able to cherish the time you did have with him. I also expect that you will be more involved at that point with the rest of your life. I suggest that you continue to reach out to others who also loved your grandpa to share memories and feelings. That will help with the grieving process.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I know this is going to sound out of place but I know I need help before my health takes a bigger toll. I have what some call a broken heart my primary physician hasn’t find anything, my endocrinologist have been keeping a close eye on my thyroid, cholesterol and diabetes count the all appear to be under control. I was in a long term relationship with a man that had worked hard for most of his adult life. He participated on several drug interdiction missions in Central and South America before I met him. When we met he was going through Chemo and radiation treatment for prostate cancer and had lost his mom the year before to breast cancer. The relationship was hard at that time but beautiful. The following year he was forced to retired due to other issues that he had plus time in service. About six month later he was cleared by his oncologist and went to Iraq and while there my mom passed away. [He could not be without the adrenaline rush of dangerous jobs, earning good wages, etc...] When mom died had to be the strong rock that everyone lean on shedding the least tears possible to stay strong. This man called me at every opportunity he had to give me the support I needed. After his two tours/contracts in Iraq were over and my dad passing away two years after my mom[same scenario I had to be strong, had to clean up the house that had been emptied since mom died without any support] our relationship seem to had become stronger than ever. He made sure that I was ok even sent me flowers to make my day better. We had plans for our future together. About a year later he went to Afghanistan, this is when my issues started. I read every book that I came across regarding PTSD and other problems that families and love ones have to face when these men and women in the front lines come back. With him being a civilian contractor things are a bit different because the support from the medical community isn’t there as it is for the military. Him being as active as he is and having work undercover for over 20 years showing emotion wasn’t or isn’t easy for him. I was as supportive as humanly possible everything he needed or wanted I would find the way to shipped it same or next day, we even Skyped even when I was at work just to make sure he knew I had his back. After his second tour to Afghanistan our relationship really took a tumble. He became isolated. I had prepared myself for just about anything except for who came back. Slowly, he pushed me away without an explanation or a reason. There hasn’t been a book written that addresses the fact that a love one can actually come home alive but dead to the person he/she is planning to spend the rest of the life with. I tried everything without being to pushy(I didn’t want him to snap as I knew he could have given his background training.) Then to make matters worse I had to have cervical spine surgery two years ago which exacerbated my menopause symptoms. He chose to be gone when I had my surgery and while recovering (which I did as expected 99%)he only visited me once or twice later demanding a relationship that was not possible for me to give to anyone. Ever since that second tour I’ve been experiencing severe “anxiety” attacks. Lately and after I had enough of this stranger visiting and staying with me whenever he felt like, I told him to take the high road. I had mourn the relationship a lot between the time he almost got blown up in Afghanistan along with other instructors from Australia and the time I ended the relationship. It physically hurts a lot not to have answers as of what truly happened that he pushed me away to the point of no return and who or what happened to the people in his nightmares which he called out loud. Today, has been a year since the breakup. I still have anxiety, horrible chest pains, shortness of breath that are becoming more frequent. In addition to all of that my youngest daughter divorced and left her child with her ex in Germany. When I was told my heart literally sank felt like a death of a love one had taken place my world ended. My oldest grandson who is 15 is following the wrong steps and I worry. I have try to cope but it isn’t enough for me to just cope I need more than that. I need the support that my girls cannot give me . They are dealing with their own demons and counting on me to be the strong one for them but it is becoming harder to the point that all my symptoms of anger and dispair are taking a physical shape in the way of chest pain sometimes sharp but lasting no longer than a minute or two, severe anxiety even my coworkers void me because of my anger."M1l0Gros, Support Network Member
"Your story is indeed heart-breaking. It is also quite complicated; I cannot do it justice in a short response. I suggest seeking psychotherapy for yourself to deal with your grief and to better understand the symptoms of PTSD. My hope is also that your therapist would help you begin turning your life toward the future again and perhaps healthier and happier relationships. It will take you a long time to heal. Please be good to yourself and reach out for professional help.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I am in a community that is very isolated from friends and family and I am really depressed"Peggy1961, Support Network Member
"There have been multiple research reports this year about the negative impacts on health of social isolation and loneliness. It is very important therefore to combat isolation through reconnecting with others. Please raise your concerns with your primary care provider so that he or she can evaluate you for clinical depression. If it is not possible to move closer to family, then can you reach out to them via the phone or texting or social media? And can you make friends, perhaps through a church or community group, where you now live? It will take time and effort. Can you try?—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"how to not get depression post open heart surgery at 60."dederuth, Support Network Member
"About 15-20% of heart surgery patients will become clinically depressed following surgery. Those most at risk include people with a previous or family history of depression. If you don’t have such a history, then the likelihood is that you won’t get depressed. But there are also other steps you can take: Stay connected to others—i.e., don’t withdraw socially. Express whatever your feelings to people who are good listeners. And remain as physically active as your physician suggests; cardiac rehab programs serve this function well.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"My blood pressure is 111/156. What should I do?"SangeetaDevi, Support Network Member
"Thank you for this question. Make an appointment with your Primary Care Provider ASAP. Have annual blood work done if you have not already done so. Hypertension is known as a Silent Killer because you can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.Kimaka Bowens, MSN, APRN, FNP-C,
Thank you, Kimaka Bowens, MSN, APRN, FNP-C"