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Suggest Treatment For Damage To Femoral Artery
Question: Answer me please :Should I have been a subject of a heart Ablation after 3 short episodes of PAF ? The specialist doctor of Ablation choose not to treat me at all apart from 14 days with Flecainide 100mg prior to the procedure saying that this is the only way of a cure for life from PAF.My Chads Vasc score had been 1 based on Echocardiogram report with mild left atrial dilation ,no significant valvular abnormalities ,good ventricular function (direct reading of the report ).Incidentally I was injured by this doctor resulting in 35 days of hospitalization for the damaged a femoral artery .I am 77 years old woman of a good health otherwise .
Kind regards
XXXX
Kind regards
XXXX
Brief Answer:
Not required for three short episodes.
Detailed Answer:
Hello
Welcome to Health Care Magic.
My name is Dr Muhammad Ahmad & i will look into your problem.
I have gone through your query and would try to help you in the best possible way.I understand you concern and being a resident of cardiology myself, I will try to explain the whole thing to you.
My opinion:
I have read your history and description in detail and I should congratulate you for having such a fine heart in 77.
Your echo tells me that your heart has been safe from any issues all those years. Your Chads vasc score would have been 3 if we include your age(+2) and female sex(+1) but when a patient shows a fine heart in echo then we exclude age factor out of it,this probably happened in your case, your heart looked fine to the echo personnel and he didn't add +2 points of your age into the score and declared it 1.
When do Go for ablation:
1- High CHads Vasc score:
This alone isn't considered a criteria for ablation but it tells you risk of future A-Fib which in your case seems to be minor .
2- When A-fib is chronic:
There are many people who suffer days and days of A-fib and that never goes away with medication then we decide for ablation.
3- When there is heart failure:
When a patient has heart failure, A-fib can effect his/heart heart's function(stroke volume) by 40-50 percent so in such patient if A-fib doesn't settle with meds we go for ablation.
4- Post MI high risks.
5- When a patient repeatedly faces haemodynamic instability during A-fib episodes.
6- Really suggestive Holters monitoring.
YOUR CASE:
Of all the Six points mentioned above you DON'T fit in, on a single criteria for ablation, and ablation would not be necessary if you are doing fine with or without medication.
My suggestions:
1- Take good care of you , your blood pressure and cholesterol.
2- Go for regular follow up visits as scheduled by your doctors.
3- Use recommended medicines regularly.
4- Ablation is not required if things keep going well for you, keep noting down when ever you have A-fib and for how much time it stayed there, so that you can further discuss your options with the doctor.
5- Its always better to avoid unnecessary invasive procedures, if they are not required. Sending a catheter up your heart and cauterizing (freezing) an area of muscle, has it's own risks , pros and cons and no doctor wants to risk his patients safety for a procedure which could have avoided.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Not required for three short episodes.
Detailed Answer:
Hello
Welcome to Health Care Magic.
My name is Dr Muhammad Ahmad & i will look into your problem.
I have gone through your query and would try to help you in the best possible way.I understand you concern and being a resident of cardiology myself, I will try to explain the whole thing to you.
My opinion:
I have read your history and description in detail and I should congratulate you for having such a fine heart in 77.
Your echo tells me that your heart has been safe from any issues all those years. Your Chads vasc score would have been 3 if we include your age(+2) and female sex(+1) but when a patient shows a fine heart in echo then we exclude age factor out of it,this probably happened in your case, your heart looked fine to the echo personnel and he didn't add +2 points of your age into the score and declared it 1.
When do Go for ablation:
1- High CHads Vasc score:
This alone isn't considered a criteria for ablation but it tells you risk of future A-Fib which in your case seems to be minor .
2- When A-fib is chronic:
There are many people who suffer days and days of A-fib and that never goes away with medication then we decide for ablation.
3- When there is heart failure:
When a patient has heart failure, A-fib can effect his/heart heart's function(stroke volume) by 40-50 percent so in such patient if A-fib doesn't settle with meds we go for ablation.
4- Post MI high risks.
5- When a patient repeatedly faces haemodynamic instability during A-fib episodes.
6- Really suggestive Holters monitoring.
YOUR CASE:
Of all the Six points mentioned above you DON'T fit in, on a single criteria for ablation, and ablation would not be necessary if you are doing fine with or without medication.
My suggestions:
1- Take good care of you , your blood pressure and cholesterol.
2- Go for regular follow up visits as scheduled by your doctors.
3- Use recommended medicines regularly.
4- Ablation is not required if things keep going well for you, keep noting down when ever you have A-fib and for how much time it stayed there, so that you can further discuss your options with the doctor.
5- Its always better to avoid unnecessary invasive procedures, if they are not required. Sending a catheter up your heart and cauterizing (freezing) an area of muscle, has it's own risks , pros and cons and no doctor wants to risk his patients safety for a procedure which could have avoided.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Dr XXXXXXX XXXXXXX ,
Thank you very much for your professional and most detailed information re- my query .I was certain that I should not be ablated knowing that I was not feeling sick at all .I did survive without any medication since 2012 August when the first attack took place in Macau after a long flight from Sydney to HK .I had a bad cold and a pharmacist in Sydney airport gave me a dose of tablets which had antihistamine in it .It definitely triggered the attack for the first time in my life .
Doctors in Emergency Hospital did prescribe a low dose aspirin only .
I could travel further to Europe after a night of rest in the hospital .
In Poland one of the cardiologist doctor prescribed Plavix and Metoprolol which was stopped by the ablation doctor soon after my return home .He promised to treat me with medications if/when another PAF recurred .
Since that time no medication was applied and the 2nd episode last year on 27th Dec reverted itself spontaneously without any help .
Then this year on 17 January I had called an ambulance to take me to a hospital with a heart bit of 150 /min .It reverted as well with a help of a drip of medication .This was the only reason which ablation doctor was deciding to perform the procedure without any treatment apart of the 14 days Flecainide tablets .
I am glad to be alive after bleeding to death for the next 38 hrs after the Ablation .The culprit doctor did not assist in confessing of the injure before the cat-scan ,he was absent personally ,only communicating in last minutes on XXXXXXX phone with doctors of surgery .
The operation for the damaged femoral artery resolved in 2 L blood loss ,3 hrs of operation ,7 hrs in ICU ,35 days in hospital for the infected wound with ESBL bacteria ,24 days of H@H care of nurses giving me drips of antibiotics and dressing the wound .
I will follow your advice but from then only I never would agree for any procedure on my heart for the rest of my life .
Regards
XXXX
Thank you very much for your professional and most detailed information re- my query .I was certain that I should not be ablated knowing that I was not feeling sick at all .I did survive without any medication since 2012 August when the first attack took place in Macau after a long flight from Sydney to HK .I had a bad cold and a pharmacist in Sydney airport gave me a dose of tablets which had antihistamine in it .It definitely triggered the attack for the first time in my life .
Doctors in Emergency Hospital did prescribe a low dose aspirin only .
I could travel further to Europe after a night of rest in the hospital .
In Poland one of the cardiologist doctor prescribed Plavix and Metoprolol which was stopped by the ablation doctor soon after my return home .He promised to treat me with medications if/when another PAF recurred .
Since that time no medication was applied and the 2nd episode last year on 27th Dec reverted itself spontaneously without any help .
Then this year on 17 January I had called an ambulance to take me to a hospital with a heart bit of 150 /min .It reverted as well with a help of a drip of medication .This was the only reason which ablation doctor was deciding to perform the procedure without any treatment apart of the 14 days Flecainide tablets .
I am glad to be alive after bleeding to death for the next 38 hrs after the Ablation .The culprit doctor did not assist in confessing of the injure before the cat-scan ,he was absent personally ,only communicating in last minutes on XXXXXXX phone with doctors of surgery .
The operation for the damaged femoral artery resolved in 2 L blood loss ,3 hrs of operation ,7 hrs in ICU ,35 days in hospital for the infected wound with ESBL bacteria ,24 days of H@H care of nurses giving me drips of antibiotics and dressing the wound .
I will follow your advice but from then only I never would agree for any procedure on my heart for the rest of my life .
Regards
XXXX
Brief Answer:
Please always consider the better option, stay flexible.
Detailed Answer:
Hello,
Thanks for writing back.
Thanks for showing your trust, it's my pleasure.
What ever happened to you was tragic but I am pleased that you came out of it healthy and alive, i want to assure you mam that no doctor ever wants to hurt his patient, interventions have their own risk and sometimes despite all the care you take disasters, but i am pleased you are healthy and safe.
What ever i said earlier in my previous answer was my own opinion, your attending doctor may differ or may have a different criteria of going for intervention, he was right this the best procedure to cure it permanently but again a surgery is a surgery after all and if you get one episode after a year which settles by itself, i think one can wait before going this far.
You said you will not go for any procedure to you heart in future, mam i would like to ask you to stay flexible in this regard, i might not need it today but some day it may get necessary for you so i would like to ask you to consider all you options in future if things go well then you wont need ablation any way but some day when you actually need it please consent to it , before that you can talk to a dozen cardiologist , take second,third,fourth,fifth opinion but when it get's necessary , you gotta go for it .
Stay blessed have a healthy life. If you have more questions i am happy to answer if not, then you can rate my answers and close the discussion. Wish you the best of health.
Dr Muhammad XXXXXXX
M.B.B.S
M.D (Cardiology)- Resident.
Please always consider the better option, stay flexible.
Detailed Answer:
Hello,
Thanks for writing back.
Thanks for showing your trust, it's my pleasure.
What ever happened to you was tragic but I am pleased that you came out of it healthy and alive, i want to assure you mam that no doctor ever wants to hurt his patient, interventions have their own risk and sometimes despite all the care you take disasters, but i am pleased you are healthy and safe.
What ever i said earlier in my previous answer was my own opinion, your attending doctor may differ or may have a different criteria of going for intervention, he was right this the best procedure to cure it permanently but again a surgery is a surgery after all and if you get one episode after a year which settles by itself, i think one can wait before going this far.
You said you will not go for any procedure to you heart in future, mam i would like to ask you to stay flexible in this regard, i might not need it today but some day it may get necessary for you so i would like to ask you to consider all you options in future if things go well then you wont need ablation any way but some day when you actually need it please consent to it , before that you can talk to a dozen cardiologist , take second,third,fourth,fifth opinion but when it get's necessary , you gotta go for it .
Stay blessed have a healthy life. If you have more questions i am happy to answer if not, then you can rate my answers and close the discussion. Wish you the best of health.
Dr Muhammad XXXXXXX
M.B.B.S
M.D (Cardiology)- Resident.
Above answer was peer-reviewed by :
Dr. Raju A.T
I wish I could deal with a different more careful doctor in regards of the heart care .I understand an intention of this doctor to help me for life but he was thinking in the first instance of a quick approach ignoring an ethical site of his profession .I was a private patient therefore a target for the profit making procedure .Being an experience doctor he should follow totally the present guideline before doing an ablation .If I would not be ablated then the complications would not have occurred and my medical outcome would have been very different .
I can be thanks to my Mum's genes who lived 96+ years .
Once again I thank you very much for willing to give me a thorough attention unlike this doctor who hardly knew me and the 3 visits to him were lasting 5-8 minutes only .
I wish you a happy and most successful 2015 year in your carrier .
Blessings
XXXX
I can be thanks to my Mum's genes who lived 96+ years .
Once again I thank you very much for willing to give me a thorough attention unlike this doctor who hardly knew me and the 3 visits to him were lasting 5-8 minutes only .
I wish you a happy and most successful 2015 year in your carrier .
Blessings
XXXX
Brief Answer:
Hopefully you will not be having any issues in future.
Detailed Answer:
Hi,
Actually in your case you don't even need medication for arrhythmia because there is no point of continuously popping in pills when one gets the problem once a year.
What you need is, care and a healthy lifestyle , hopefully you will not need any procedure done in future.
It's always my priority to give thorough attention to my patients , after all a doctor is one person whom you tell your fears too, and you definitely want him to do something about it.It's not just about writing a prescription or advising a procedure sometimes, alleviating fears and doubts and educating you patient is very important.
I got to congratulate you that you are well on your way to, should i say, "out-live" your mother. When ever you have questions you can post your questions directly to me through " direct question " option and that would be me answering you .
Thanks for your wishes , i am indeed honored and blessed to meet such kind people across the globe.
Stay blessed.Live healthy. Have a great new year ,a healthy and happy one:)
Don't forget to rate the answers and giving your kind feedback for my own betterment.
Wish you health.
Hopefully you will not be having any issues in future.
Detailed Answer:
Hi,
Actually in your case you don't even need medication for arrhythmia because there is no point of continuously popping in pills when one gets the problem once a year.
What you need is, care and a healthy lifestyle , hopefully you will not need any procedure done in future.
It's always my priority to give thorough attention to my patients , after all a doctor is one person whom you tell your fears too, and you definitely want him to do something about it.It's not just about writing a prescription or advising a procedure sometimes, alleviating fears and doubts and educating you patient is very important.
I got to congratulate you that you are well on your way to, should i say, "out-live" your mother. When ever you have questions you can post your questions directly to me through " direct question " option and that would be me answering you .
Thanks for your wishes , i am indeed honored and blessed to meet such kind people across the globe.
Stay blessed.Live healthy. Have a great new year ,a healthy and happy one:)
Don't forget to rate the answers and giving your kind feedback for my own betterment.
Wish you health.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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