Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Do Unusual Swelling In The Legs And Abdomen, Lack Of Appetite And Fatigue Require Immediate ER Consultation?
Question: Hello. My 91 year old father finished his antibiotics and did some tests including blood tests for a respiratory infection with fairly normal results. However he has begun to develop swelling in his legs and abdomen and continues not to have appetite, and is tired. He is supposed to see a doctor on Monday for the results of a. CAT. But I told my mother he should go to the emergency instead of waiting until Monday. What does this situation sound like to you? His cardiovascular and blood pressure are basically normal too. Thank you.
-----------------------------------------------------------------
Thank you. How is it possible for right heart failure so suddenly? He's had heart tests that were normal in the past. For his age his over all health has been good. Is there an immediate cause for sudden failure, and is it reversible? Should he go to the emergency now?
----------------------------------------------------------------
-----------------------------------------------------------------
Thank you. How is it possible for right heart failure so suddenly? He's had heart tests that were normal in the past. For his age his over all health has been good. Is there an immediate cause for sudden failure, and is it reversible? Should he go to the emergency now?
----------------------------------------------------------------
Brief Answer:
Sounds like heart failure.
Detailed Answer:
Hello,
The combination of these symptoms are usually caused by right heart failure. Heart failure is not uncommon in 91-year-old individuals.
Here's a list of good reasons to visit the ER before the scheduled appointment:
- Shortness of breath
- Low urine output
- Confusion
The list is not complete. Any important symptom can be a part of it but I've mentioned some 'red flags'.
If you'd upload the reports, I could get a better idea of his current condition. You can use your follow-up questions to do so.
Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
----------------------------------------------------------------
Brief Answer:
Please read the complete answer
Detailed Answer:
Hello,
Let me start by making clear that I can't diagnose anything from afar (obviously), therefore, please understand that I'm just suggesting potential causes for his symptoms.
I wouldn't expect right heart failure to present all of a sudden but it is possible that he had some degree of heart failure in the past. If he has an ultrasound scan of the heart (echo), signs of right heart failure might be found there.
Sudden right heart failure may occur after a cardiovascular event like acute myocardial infarction or pulmonary embolism. Right heart failure is usually treatable. Right heart failure in itself is not sufficient a reason to visit the ER. When it is serious enough to cause some (or all) of the symptoms I've mentioned in my previous answer then the visit to the ER cannot be avoided.
If he's stable (no shortness of breath, good communication, adequate urine output, stable blood pressure and pulse rate) then he can wait until he sees his doctor.
Other potential causes may include proteinuria, venous insufficiency, thrombotic events (bilateral presentation is uncommon), side effects (for example caused by calcium channel blockers like Amlodipine) etc.
Hope I have answered your query.
Thank you.
Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
---------------------------------------------------------------
Sounds like heart failure.
Detailed Answer:
Hello,
The combination of these symptoms are usually caused by right heart failure. Heart failure is not uncommon in 91-year-old individuals.
Here's a list of good reasons to visit the ER before the scheduled appointment:
- Shortness of breath
- Low urine output
- Confusion
The list is not complete. Any important symptom can be a part of it but I've mentioned some 'red flags'.
If you'd upload the reports, I could get a better idea of his current condition. You can use your follow-up questions to do so.
Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
----------------------------------------------------------------
Brief Answer:
Please read the complete answer
Detailed Answer:
Hello,
Let me start by making clear that I can't diagnose anything from afar (obviously), therefore, please understand that I'm just suggesting potential causes for his symptoms.
I wouldn't expect right heart failure to present all of a sudden but it is possible that he had some degree of heart failure in the past. If he has an ultrasound scan of the heart (echo), signs of right heart failure might be found there.
Sudden right heart failure may occur after a cardiovascular event like acute myocardial infarction or pulmonary embolism. Right heart failure is usually treatable. Right heart failure in itself is not sufficient a reason to visit the ER. When it is serious enough to cause some (or all) of the symptoms I've mentioned in my previous answer then the visit to the ER cannot be avoided.
If he's stable (no shortness of breath, good communication, adequate urine output, stable blood pressure and pulse rate) then he can wait until he sees his doctor.
Other potential causes may include proteinuria, venous insufficiency, thrombotic events (bilateral presentation is uncommon), side effects (for example caused by calcium channel blockers like Amlodipine) etc.
Hope I have answered your query.
Thank you.
Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
---------------------------------------------------------------
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
