What Is The Prognosis For Cardiomegaly And Esophageal Varices While Having A History Of Chronic COPD, Rapid Heart Rate And Swollen Legs?

Posted on Mon, 29 Jan 2018

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

Mon, 29 Jan 2018 Answered on

Tue, 11 Sep 2018 Last reviewed on

Question : My father is 57 years old having breathlessness at night requiring 3 pillows to breathe comfortably. He suffers from COPD for 11 years probably from smoking heavily. The bp is normal but he has rapid heart rate and prominent neck veins, a bluish complexion and swelling in his legs and feet. His liver tests are elevated (AST, ALP and BUN) and his chest x-ray shows "cardiomegaly" and esophageal varices. What does this mean.
what kind of doctor should we visit/consult? Cardiologist or internist?

Answered by Dr. Indranil Ghosh (21 minutes later)

Brief Answer:
Suggests cardiac failure

Detailed Answer:
Hi,
Thanks for your query. I understand your concerns.

All the features you mentioned are in favor of heart failure. It might have resulted from lung damage due to smoking and COPD. So it may be a secondary event.

He needs urgent evaluation and treatment under a cardiologist. The cardiologist may also like to get him reviewed by a pulmonologist.

Hope I have answered your query. Let me know if I can assist you further.

Regards
Dr. Indranil Ghosh,
Oncologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Indranil Ghosh (8 hours later)

Thank you. How do you suggest we manage this condition? And what diagnostic tests do you suggest?

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
Medicines to improve the cardiac function

Detailed Answer:
We usually do ECG, echocardiogram, chest x-ray to confirm the diagnosis. Then management involves medicines to increase the urine output, increase the pumping function of the heart and the reduction of high blood pressure. With these measures, symptomatic improvement is expected.

His cardiologist will be able to suggest the exact line of treatment after reviewing him.
Hope I have answered your query. Let me know if I can assist you further.

Regards
Dr. Indranil Ghosh,
Oncologist

Above answer was peer-reviewed by : Dr. Yogesh D