Having Dizziness And SOB. Has Embolism On Coumadine. On Beta Blocker. Safe?

Posted on Fri, 24 May 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 24 May 2013 Answered on

Sun, 16 Jun 2013 Last reviewed on

Question : My mother just had a heart XXXXXXX and is now on beta blocker. SHe is continuing to have dizzines confusion and SOB with mild activity. THe said she did not have blockage and did not need STENTS or surgery. SHe also has hx of embolism and is on coumadine. Phlebitis and cellulitus.

Answered by Dr. Anantharamakrishnan (2 hours later)

Hi friend,
Welcome to Health Care Magic

She is already on Beta-blockers and anticoagulant / needs no more medicines for the heart. Your mother’s angiogram report is reassuring...That means other systems need to have a look...
     Next to heart, Lung is the cause for SoB – CT chest and Lung function test (Spirometry) will evaluate the anatomy (structure) and Physiology (function) respectively. Pulmonologist can help

      Dizziness is vague term - unsteadiness. If there is definite sense of rotation, it is vertigo. If it is from getting up from bed, it may be from postural hypo-tension.. Check her BP, lying and standing / It can be from anaemia – Check her haemoglobin?
     The body's balancing mechanism is in the inner ear. An ENT (Ear Nose Throat) specialist is the one to evaluate. They have special tests to confirm or exclude the contribution of the ear.
     If there are no clues -and especially because of confusion – she should be seen by a neurologist. Cerebro- vascular insufficiency / even bleeding because of Warfarin – have to be excluded / MRI and MRA (MRI Angiography) may be necessary

Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (18 hours later)

She has had the ENT and has been checking the BP. SHe is scheduled to see a neurologist. THey ruled out vertigo. She seems to not process the information you give her and she is needing you to states things over and over to write them down. Can she be having a slow bleed in her brain even though her coumadine levels are closely monitored???? Can she have another embolism even on coumadine????

Answered by Dr. Anantharamakrishnan (5 hours later)

Yes...
Bleeding or embolism is possible, in spite of tight control of the anticoagulant.

Atherosclerosis (thickening from age, lipids and so on) involving the blood vessels of the brain may be responsible leading to loss of memory for recent events, inattention and so on... Diffuse degeneration / Alzheimer might also be responsible...
Neurologist can clarify

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar