Shortness Of Breath

[jadyn]

A friend of mine who suffers from severe congestive heart failure has asked me a question that no matter where I look on the internet, I can't find an answer.

He's taking maximum doses of a number of drugs namely Ramipril, Candesartan, Digoxin, Bisoprolol, ISMO, Bumetanide, Metolazone, Spironolactone and Amlodipine for the Class 3/4 heart failure ( I think this is the class his consultant said).

He is very short of breath most of the time and becomes very frightened as he feels there is "not enough oxygen in the air". However, he's discovered that one or more of the drugs he's taking results in a marked improvement in his ability to breath and he's asked me to find out which one it's likely to be. I have no idea about this and I suspect this situation has arisen as he's not very good at monitoring exactly what tablets he's taking daily although I'm trying to get a regime going for him.

I know that the diuretics are important as he says that he can feel fluid in his lungs if he doesn't take the diuretics and I know he becomes wheezy and hoarse as a consequence. He also has something called ascites and quite an enlarged abdomen. He doesn't think that the fluid clearance alone from his lungs eases his breathing to the extent that it does and thinks one of the other drugs may be doing the job as he often feels breathless with no fluid on his lungs.

Thank you.

[Jackdaw33]

If Sqad sees this post I'm sure he will reply. This question needs a professional's opinion.

[hellywelly4]

Not answering your question, I know, but I think the pharmacist will make up his tablets in daily boxes, then he just takes them as needed. If he is having problems, that could help.

[bednobs]

it's a case of all of them working, but in different ways. Cardiac failure (inability of the heart to pump effectively) causes a back up of fluid into the lungs. The diuretics will help relieve this. However, the drugs tht are trting to make his heart work more effectively will also help by making so the fluid has less chance to bckflow.

[Sqad]

Take your pick.

This guy has marked Hypertensive Congestive Cardiac Failure and by the look of the diuretics he is taking particularly Bumetanide and Spironolactone he does indeed have a marked "back pressure" from his heart failure.
Drugs to lower his BP, beta blockers and the rest.....and he still has ascites.

This guy is coming to his natural end and i cannot see ANY of the drugs which would account for "easing of his breathing."

That is all i have to say.

[anneasquith]

Such dreadful position to be in. Could he have his medication reviewed and as stated discuss with pharmacy the administration packs could be supplied.

[EDDIE51]

Just a guess, but could it be that often he does not take his full range of drugs correctly but when he does get it right he feels a lot better? Monitoring his dosage seems a very good idea!

[jadyn]

Thank you all. I intend contacting his pharmacy this week to see if he can have his medication delivered in blister packs to try to stop this situation continuing. No doubt he'll need it explained to him.

I realise that the future looks ominous for him but to be honest, his condition has remained more or less stable for around two years now and the only things that are getting worse are the breathing and tiredness. He's managed to acquire consultant cardiologists at two local general hospitals plus a renowned expert in heart failure at the tertiary hospital nearest to his home. He only has to pick up a phone to get himself seen!

I really wouldn't have predicted he'd still be alive today when I saw him in A&E with clear fluid dripping out of unbroken skin just above his ankles due to severe oedema and the start of something I think was called cardiogenic shock.

Many thanks for all your advice.