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On pacemaker and Amiodarone developed swelling of feet

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Hello Doctor,

Thank you for yout input in advancce.

Due to Irregular heart beat problems , my dad was recommended to have a pace maker installed and he did so almost a month and a half ago. (spikes of high heart beat were noticed at times, but his average heard beat is usually at low 40-50s)
A week after the operation, he started taking Amiodrane and Asprin 81 mg to as recommended by his cardiologost to treat his irregular heat beat .
Due to some fainting / seizure like symptoms he had to visit hospital again last week and later he was recomended to stop taking his blood pressure pill.

Now it has been a few days that i've noticed an increasing lower ankle and mainly feet swelling. (on both legs, when you press a swollen spot, the skin will stay down and slowly recovers, not right away )

I contacted his family doctor to arrange a visit but he wasn't available until saturday.

I've searched and read that Amiodrane has a long list of possibe side effects including swelling of feets and thought that may be the reason behind.

And i'm wondering if this is something that has to be treated with emergency or we can wait until his doctor becomes available. and if there any risks of having feets left swollen ?

I'd also appreciate any suggesten on how we can control this. I've been trying to give foot massages once a day, not sure if that helps but been basically trying to help with blood circulation.

Thanks very much.

Sal


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello,

Thank you for your query at DoctorSpring.com.

I have gone through your history and picture attached. From the data available your father has probably atrial fibrillation with intermittent slow and fast ventricular rates. The pacemaker treats the slow rate but drugs like amiodarone or beta blocker may be required to treat the fast rate. Your father probably suffered from postural hypotension in which bp fell excessively secondary to anti hypertensive medications. And so they were stopped most likely.

Was the pacemaker interrogated or checked when he had that fainting type of episode?
Was the pacemaker functioning properly during that interrogation?
Was your father on drugs that increase urine output?
Has your father undergone an echo examination?
If yes what was his ejection fraction?
Has your father undergone renal functional tests?
If yes what is his creatinine?
What is his hemoglobin if you have tested it?
Is the swelling painful?

Pedal edema in both feet could be due to cardiac renal liver causes and severe anemia. If the urine output is normal then the other causes are not a dire emergency but need to be investigated.
If the urine output is normal then you could restrict his fluids to around 1.3 litres per day and salts to 2 g per day so as to reduce the edema.

Limb elevation will also help

Hope this helps, please feel free to discuss further
Regards
Dr Vivek Mahajan
DM Cardiology


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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