Instruction: Is there a way to get a coroner to do it? The county coroner said they won't since the surgeon signed off on it, so as far as I'm aware I need to get a private autopsy done, which is a pretty large financial burden at around $7,000. I'll absolutely pay for it if it's at all likely that they messed up. I can't stand the thought that they could face no repercussions for any mistakes they made.

Output: Its really hard to connect a sudden event like this to a relatively benign surgery i.e. toe amputation. I cant envision a scenario where the surgery was a direct cause of his death. If it was a PE and he wasnt getting SQ heparin in the hospital, maybe you have a case, but even that might be a stretch. The vast majority of deaths in the hospital were beyond anyones control, but of course there are exceptions. Despite popular belief, its hard to kill people.I think it's most likely that they didn't make any mistake that caused this death, especially with just an amp of a digit, but I would think this definitely would deserve an autopsy. He probably had a PE, STEMI, something catastrophic either unrelated to the surgery or a very unfortunate complication of the surgery, and was in a part of the hospital for very non-acute patients that don't really need much monitoring when it happened.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Is there a way to get a coroner to do it? The county coroner said they won't since the surgeon signed off on it, so as far as I'm aware I need to get a private autopsy done, which is a pretty large financial burden at around $7,000. I'll absolutely pay for it if it's at all likely that they messed up. I can't stand the thought that they could face no repercussions for any mistakes they made.. ### Response: Its really hard to connect a sudden event like this to a relatively benign surgery i.e. toe amputation. I cant envision a scenario where the surgery was a direct cause of his death. If it was a PE and he wasnt getting SQ heparin in the hospital, maybe you have a case, but even that might be a stretch. The vast majority of deaths in the hospital were beyond anyones control, but of course there are exceptions. Despite popular belief, its hard to kill people.I think it's most likely that they didn't make any mistake that caused this death, especially with just an amp of a digit, but I would think this definitely would deserve an autopsy. He probably had a PE, STEMI, something catastrophic either unrelated to the surgery or a very unfortunate complication of the surgery, and was in a part of the hospital for very non-acute patients that don't really need much monitoring when it happened..


Instruction: Im a 32 year old male, smoked tobacco from 18-22 and switched to vaping, regular use of marijuana and no other drug use since age 22, I used to abuse cocaine. Went to the ER twice, once for a short lived but stabbing center chest pain, other visit I was sitting watching videos and my heart started pounding out of my chest and reach 150-160bpm, but absent of pain, both times EKG and X-ray were explained as unremarkable and was given an ER diagnosis of palpitations/anxiety. I went to my PCP yesterday and he asked if any of the ER staff mentioned a incomplete RBBB. I told him they did not, I reached out to ER doctor and he said the computer read out printed an incomplete RBBB on the paper but upon human examination it wasnt the case and was likely caused by me being underweight. My PCP said this is highly unlikely and ordered a chemical stress test and a cardiology appointment for May 5th, I trust my PCP but hes new to me so I dont know him very well. Can an EKG false read a RBBB or is my PCP correct to be suspicious? If I do have an Incomplete RBBB what does that mean for someone my age? Waiting on the next appointment is giving me anxiety and just want to understand more about whats happening. Thank you in advance for your help! I have a family history of stroke but not cardiac failure.

Output: An incomplete RBBB is generally a benign and incidental finding. I would not worry about it at all. I often dont mention it to patients if I see it on their EKG because it doesnt really meaningfully increase risk of anything nor does it typically indicate underlying cardiac disease. Think if it as simply just being the way your heart is wired.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Im a 32 year old male, smoked tobacco from 18-22 and switched to vaping, regular use of marijuana and no other drug use since age 22, I used to abuse cocaine. Went to the ER twice, once for a short lived but stabbing center chest pain, other visit I was sitting watching videos and my heart started pounding out of my chest and reach 150-160bpm, but absent of pain, both times EKG and X-ray were explained as unremarkable and was given an ER diagnosis of palpitations/anxiety. I went to my PCP yesterday and he asked if any of the ER staff mentioned a incomplete RBBB. I told him they did not, I reached out to ER doctor and he said the computer read out printed an incomplete RBBB on the paper but upon human examination it wasnt the case and was likely caused by me being underweight. My PCP said this is highly unlikely and ordered a chemical stress test and a cardiology appointment for May 5th, I trust my PCP but hes new to me so I dont know him very well. Can an EKG false read a RBBB or is my PCP correct to be suspicious? If I do have an Incomplete RBBB what does that mean for someone my age? Waiting on the next appointment is giving me anxiety and just want to understand more about whats happening. Thank you in advance for your help! I have a family history of stroke but not cardiac failure.. ### Response: An incomplete RBBB is generally a benign and incidental finding. I would not worry about it at all. I often dont mention it to patients if I see it on their EKG because it doesnt really meaningfully increase risk of anything nor does it typically indicate underlying cardiac disease. Think if it as simply just being the way your heart is wired..


Instruction: 34F, Canada, Cushings Disease with associated type 2 diabetes, hypertension, etc.One week ago I underwent a transsphenoidal pituitary adenoma resection. Midway through the surgery my heart stopped and they had to give me CPR. Not sure how long I was out for (the doctor said I was back before he had time to get the life-saving medications). My heart stopped again right at the end of the surgery. I woke up from anesthesia having my chest x-rayed and being asked a bunch of questions to see if I had any neurological damage.X-ray showed no fractures and ECGs were normal. The cardiology team didnt really know what happened and just said something about a vasovagal response with asystole. They discharged me from their care. I ended up developing diabetes insipidus so I spent 5 days in hospital.My chest still hurts something fierce. The headaches, fatigue and the hormonal rollercoaster from the tumour being removed is a walk in the park in comparison.Is the pain just muscular if the X-rays were clear? How long can I expect this to last? I feel like I cant take deep breaths or move my arms without pain. I complain but Im very grateful to the doctors who saved me!Should I be cautious going under general anesthesia in the future or was this just a freak thing?Thank you!

Output: That certainly sounds like a challenging case.You should review what happened with the anesthesiologist as they can provide the necessary context and course of events to what happened. Having the anesthetic record available will also be invaluable.Also, brain surgery carries additional risks, with significant pauses in heart rate being due to several different mechanisms. Most likely, this will not be an issue in other surgeries. However, it is impossible to know without more information.As for your chest pain, while broken ribs can happen, there can also be pain in the joints as well as muscles and other tissues. The soreness should eventually get better in the next week or so.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 34F, Canada, Cushings Disease with associated type 2 diabetes, hypertension, etc.One week ago I underwent a transsphenoidal pituitary adenoma resection. Midway through the surgery my heart stopped and they had to give me CPR. Not sure how long I was out for (the doctor said I was back before he had time to get the life-saving medications). My heart stopped again right at the end of the surgery. I woke up from anesthesia having my chest x-rayed and being asked a bunch of questions to see if I had any neurological damage.X-ray showed no fractures and ECGs were normal. The cardiology team didnt really know what happened and just said something about a vasovagal response with asystole. They discharged me from their care. I ended up developing diabetes insipidus so I spent 5 days in hospital.My chest still hurts something fierce. The headaches, fatigue and the hormonal rollercoaster from the tumour being removed is a walk in the park in comparison.Is the pain just muscular if the X-rays were clear? How long can I expect this to last? I feel like I cant take deep breaths or move my arms without pain. I complain but Im very grateful to the doctors who saved me!Should I be cautious going under general anesthesia in the future or was this just a freak thing?Thank you!. ### Response: That certainly sounds like a challenging case.You should review what happened with the anesthesiologist as they can provide the necessary context and course of events to what happened. Having the anesthetic record available will also be invaluable.Also, brain surgery carries additional risks, with significant pauses in heart rate being due to several different mechanisms. Most likely, this will not be an issue in other surgeries. However, it is impossible to know without more information.As for your chest pain, while broken ribs can happen, there can also be pain in the joints as well as muscles and other tissues. The soreness should eventually get better in the next week or so..


Instruction: Thank you! Yes all the doctors seem a bit mystified by it. I have follow-ups with the surgeons in a couple weeks so I will get more details. I admit to feeling a bit freaked out by the experience. And the chest pain has been killer.

Output: Broken ribs are notoriously hard to see on X-rays  were looking more for breaks that are also very out of place, or a collapsed lung from the fracture. So you could very well have a broken rib that wasnt seen.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you! Yes all the doctors seem a bit mystified by it. I have follow-ups with the surgeons in a couple weeks so I will get more details. I admit to feeling a bit freaked out by the experience. And the chest pain has been killer.. ### Response: Broken ribs are notoriously hard to see on X-rays  were looking more for breaks that are also very out of place, or a collapsed lung from the fracture. So you could very well have a broken rib that wasnt seen..


Instruction: 26F. 510, 150lbs. Non smoker, exercise 2x per week.I had an episode a few weeks ago where I felt lightheaded for about 15 minutes. I also had heart palpitations and feel very anxious (heart palpitations started after light headedness). This improved with deep breaths. I havent had an episode like this previously but have in the past felt heart palpitations when stressed.I spoke to a doctor at the time who sent me to the ER. I had blood tests, 2 ECGs, blood pressure tests and an X-ray which were all normal, but was sent to cardiology as a follow up.I have also since spoke with a GP who said they likely think my symptoms were a panic attack as I do suffer from anxiety and health anxiety. That said, I still have to see a cardiologist to confirm.I have my appointment tomorrow and Im very anxious about it. What will happen? Whats the likeliness of needing further tests and what would they be? Im worried about having to do a lot of follow up tests as Im travelling soon and need to be fit to travel

Output: They might just talk to you about your symptoms and what happened. Family heart disease history. Might have you wear a heart monitor to catch any arrhythmias that might happen if/when you feel lightheaded etc. or do an echocardiogram but I say might given that you only had one episode and all blood work / ekg are normal.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 26F. 510, 150lbs. Non smoker, exercise 2x per week.I had an episode a few weeks ago where I felt lightheaded for about 15 minutes. I also had heart palpitations and feel very anxious (heart palpitations started after light headedness). This improved with deep breaths. I havent had an episode like this previously but have in the past felt heart palpitations when stressed.I spoke to a doctor at the time who sent me to the ER. I had blood tests, 2 ECGs, blood pressure tests and an X-ray which were all normal, but was sent to cardiology as a follow up.I have also since spoke with a GP who said they likely think my symptoms were a panic attack as I do suffer from anxiety and health anxiety. That said, I still have to see a cardiologist to confirm.I have my appointment tomorrow and Im very anxious about it. What will happen? Whats the likeliness of needing further tests and what would they be? Im worried about having to do a lot of follow up tests as Im travelling soon and need to be fit to travel. ### Response: They might just talk to you about your symptoms and what happened. Family heart disease history. Might have you wear a heart monitor to catch any arrhythmias that might happen if/when you feel lightheaded etc. or do an echocardiogram but I say might given that you only had one episode and all blood work / ekg are normal..


Instruction: Gender: Male. Age: 21. Weight: 160. Diagnosed with asthma.Some months ago, I went into the emergency room for heart palpitations. I am prone to heart palpitations during anxiety, but those are caused by tachycardia. They feel like a fluttering in my chest. These heart palpitations feel like my heart stops and then THUDS into my chest. When I went into the emergency room, they were relatively infrequent. I was referred to a cardiologist.During my cardiology appointment, the doctor told me that I had a heart murmur. He ordered an echocardiogram, an MCOT monitor and a stress test. The echocardiogram came back negative for any abnormalities and I have four days left on my MCOT monitor (which is like a monitor that sits on a patch above my heart and monitors my heart rhythm 24/7). I never had the stress test done.Since that appointment, I've had these beats relatively infrequently. Maybe four times a night tops.Starting last night, I began to have them much more frequently. Much more frequently. And it is only one PM and it's happening maybe two or three times already. My question iswhen are these skipped beats concerning? When should I be worried about dying? Should I go to an emergency room?

Output: There honestly isn't any indication to go into the ER if you're wearing the MCOT monitor. While you have it on, detection of an arrhythmia is automatically transmitted to a central surveillance station for further analysis and possible intervention. If something concerning or life threatening was going on, someone would call you about it immediately.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Gender: Male. Age: 21. Weight: 160. Diagnosed with asthma.Some months ago, I went into the emergency room for heart palpitations. I am prone to heart palpitations during anxiety, but those are caused by tachycardia. They feel like a fluttering in my chest. These heart palpitations feel like my heart stops and then THUDS into my chest. When I went into the emergency room, they were relatively infrequent. I was referred to a cardiologist.During my cardiology appointment, the doctor told me that I had a heart murmur. He ordered an echocardiogram, an MCOT monitor and a stress test. The echocardiogram came back negative for any abnormalities and I have four days left on my MCOT monitor (which is like a monitor that sits on a patch above my heart and monitors my heart rhythm 24/7). I never had the stress test done.Since that appointment, I've had these beats relatively infrequently. Maybe four times a night tops.Starting last night, I began to have them much more frequently. Much more frequently. And it is only one PM and it's happening maybe two or three times already. My question iswhen are these skipped beats concerning? When should I be worried about dying? Should I go to an emergency room?. ### Response: There honestly isn't any indication to go into the ER if you're wearing the MCOT monitor. While you have it on, detection of an arrhythmia is automatically transmitted to a central surveillance station for further analysis and possible intervention. If something concerning or life threatening was going on, someone would call you about it immediately..


Instruction: Wellthe people monitoring the data have made it clear that MCOT isn't an emergency service and that all of the information from the monitor is being sent to my cardiologistwho isn't at work until tomorrow. So my thoughts are that he hasn't even seen any of my data since this has started. I just had another skipped beat. They're happening very frequently.The site says that they will only contact me if specifically requested by my physician, who isn't working weekends. I'm quite scared because these beats are happening much more frequently than normal.

Output: Are you having any other symptoms with the skipped beats? Like chest pain, shortness of breath, lightheadedness/dizziness, vision changes, or numbness/weakness/tingling anywhere, that's any different from your baseline? If so, then those would be indications to present to an ER.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Wellthe people monitoring the data have made it clear that MCOT isn't an emergency service and that all of the information from the monitor is being sent to my cardiologistwho isn't at work until tomorrow. So my thoughts are that he hasn't even seen any of my data since this has started. I just had another skipped beat. They're happening very frequently.The site says that they will only contact me if specifically requested by my physician, who isn't working weekends. I'm quite scared because these beats are happening much more frequently than normal.. ### Response: Are you having any other symptoms with the skipped beats? Like chest pain, shortness of breath, lightheadedness/dizziness, vision changes, or numbness/weakness/tingling anywhere, that's any different from your baseline? If so, then those would be indications to present to an ER..


Instruction: Whenever I have the skipped beat sensations, there's like an anxious feeling in my chest and sort of a feeling like my body is heavy. It is the same sensation that I get during panic attacks but much less severe. The sensation never lasts. It goes away immediately after the beat. I'm terrified these fuckers are going to kill me. I have no idea why all of a sudden these are happening so frequently.

Output: It sounds like PVCs (premature ventricular contractions) which feel weird but arent life threatening.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Whenever I have the skipped beat sensations, there's like an anxious feeling in my chest and sort of a feeling like my body is heavy. It is the same sensation that I get during panic attacks but much less severe. The sensation never lasts. It goes away immediately after the beat. I'm terrified these fuckers are going to kill me. I have no idea why all of a sudden these are happening so frequently.. ### Response: It sounds like PVCs (premature ventricular contractions) which feel weird but arent life threatening..


Instruction: Thank you so much! I was told I had a blockage of some kind? I cant remember exactly what its called now. Essentially the 2 parts of my heart arent in sync with each other. Thats why I got the heart monitor. Is that something to worry about?

Output: CMS/HCC is just a designation for billing stuff (CMS = Center for Medicare/Medicaid Services)."Ambulatory referral" - referral to an outpatient cardiologist (not being sent to see them urgently in the hospital)Syncope is the medical term for fainting, or becoming unconscious.The optic disc is a spot in the back of your eye where we can see the nerve that gets information from your eye and brings it to the brain. "Anomaly" just means that something looks funny (since they don't say anything else here, I can't say how it looks funny).In short, for your passing out or possible seizures, they're sending you to see a cardiologist to make sure it isn't your heart. For the funny thing they saw in the back of your eye, they're having you see an ophthalmologist. Sounds like all of this is a very reasonable workup for your issues.Hard to say with that general explanation - it'd be more helpful if you have the medical name of the condition.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you so much! I was told I had a blockage of some kind? I cant remember exactly what its called now. Essentially the 2 parts of my heart arent in sync with each other. Thats why I got the heart monitor. Is that something to worry about?. ### Response: CMS/HCC is just a designation for billing stuff (CMS = Center for Medicare/Medicaid Services)."Ambulatory referral" - referral to an outpatient cardiologist (not being sent to see them urgently in the hospital)Syncope is the medical term for fainting, or becoming unconscious.The optic disc is a spot in the back of your eye where we can see the nerve that gets information from your eye and brings it to the brain. "Anomaly" just means that something looks funny (since they don't say anything else here, I can't say how it looks funny).In short, for your passing out or possible seizures, they're sending you to see a cardiologist to make sure it isn't your heart. For the funny thing they saw in the back of your eye, they're having you see an ophthalmologist. Sounds like all of this is a very reasonable workup for your issues.Hard to say with that general explanation - it'd be more helpful if you have the medical name of the condition..


Instruction: I believe its a first degree atrioventricular block.

Output: Based on his username the original respondent is the best to answer this question though.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I believe its a first degree atrioventricular block.. ### Response: Based on his username the original respondent is the best to answer this question though..


Instruction: 27F. 213 pounds.Preexisting conditions: pcos, endometriosis, factor V, anxiety, depression, and under active thyroid Medications: propanol 40mg, levothyroxineLast year I started having random heart palpitations. I went to the ER. I had an ekg. In the ER they determined I was normal so they gave me a referral to cardiology. Since then Ive had a 30 day heart monitor, echo, and a stress test. Im told that all the results read normal and Its probably anxiety playing a part.On Friday I had a weird sensation happen. Its happened a handful of times and I mainly feel it at nighttime while laying down. It is in the middle of my chest and its a cross between a flutter and a spasm. Like it gets tight for a second. It makes me cough and I breathe in to get it to stop. I can also slightly feel them in my lower neck beating. I also woke up this morning a little weak in that area. It freaks me out.I have some slight occasional pinching just like I do with the other palpitations (Im told that can be normal ) but Im not in pain. I dont have a headache. My blood sugar is normal. My bpm is normal. My blood pressure is a little lower than where it usually sits but its still in the range.Im seeing a NP on Monday but I wanted to ask if anyone has experienced this or knows what it might be before I get told its just anxiety again.Disclaimer: Im not saying it cant be anxiety but every time I go to the doctor EVERYTHING under the sun is anxiety and its hard to get past that diagnoses when you feel like something is off

Output: The workup youve had is incredibly thorough and it couldnt find anything pathological. Short of a heart attack (which is almost impossible at your age) there wouldnt be any significant changes to your cardiac physiology since that battery of tests was done.Anxiety is by far the most likely cause.From the sounds of it, it is probably anxiety.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 27F. 213 pounds.Preexisting conditions: pcos, endometriosis, factor V, anxiety, depression, and under active thyroid Medications: propanol 40mg, levothyroxineLast year I started having random heart palpitations. I went to the ER. I had an ekg. In the ER they determined I was normal so they gave me a referral to cardiology. Since then Ive had a 30 day heart monitor, echo, and a stress test. Im told that all the results read normal and Its probably anxiety playing a part.On Friday I had a weird sensation happen. Its happened a handful of times and I mainly feel it at nighttime while laying down. It is in the middle of my chest and its a cross between a flutter and a spasm. Like it gets tight for a second. It makes me cough and I breathe in to get it to stop. I can also slightly feel them in my lower neck beating. I also woke up this morning a little weak in that area. It freaks me out.I have some slight occasional pinching just like I do with the other palpitations (Im told that can be normal ) but Im not in pain. I dont have a headache. My blood sugar is normal. My bpm is normal. My blood pressure is a little lower than where it usually sits but its still in the range.Im seeing a NP on Monday but I wanted to ask if anyone has experienced this or knows what it might be before I get told its just anxiety again.Disclaimer: Im not saying it cant be anxiety but every time I go to the doctor EVERYTHING under the sun is anxiety and its hard to get past that diagnoses when you feel like something is off. ### Response: The workup youve had is incredibly thorough and it couldnt find anything pathological. Short of a heart attack (which is almost impossible at your age) there wouldnt be any significant changes to your cardiac physiology since that battery of tests was done.Anxiety is by far the most likely cause.From the sounds of it, it is probably anxiety..


Instruction: I (24F) had an ekg done yesterday to investigate consistently high blood pressure (around 140/85 or higher) and both high (122bpm) and low (53bpm) heart rates. The ekg showed that I have a heart block and they explained that my heart is skipping beats and part of it is beating slower? They seemed pretty concerned and asked if I had any chest pain or dizziness, which I said no - but that I am almost constantly nauseated and tired.I have a lifelong history with nausea and fainting that Ive learned to control by avoiding triggers like heat, cardio, or becoming overwhelmed emotionally. They said since Ive been experiencing symptoms for so long, its probably not immediately life threatening and sent me home. But they insisted that I go to the ER if I feel like Im going to faint at any point and I was given an urgent referral to cardiology. How concerned should I be?Stats: 24F; very rarely drink, no cigarettes, no vaping, daily weed; Diagnosed with bipolar, adhd, and anxiety; Currently taking Trileptal 675mg and lexapro 10mg

Output: There are many types of heart block of various degrees of seriousness. It's not possible to say from this info what you have

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I (24F) had an ekg done yesterday to investigate consistently high blood pressure (around 140/85 or higher) and both high (122bpm) and low (53bpm) heart rates. The ekg showed that I have a heart block and they explained that my heart is skipping beats and part of it is beating slower? They seemed pretty concerned and asked if I had any chest pain or dizziness, which I said no - but that I am almost constantly nauseated and tired.I have a lifelong history with nausea and fainting that Ive learned to control by avoiding triggers like heat, cardio, or becoming overwhelmed emotionally. They said since Ive been experiencing symptoms for so long, its probably not immediately life threatening and sent me home. But they insisted that I go to the ER if I feel like Im going to faint at any point and I was given an urgent referral to cardiology. How concerned should I be?Stats: 24F; very rarely drink, no cigarettes, no vaping, daily weed; Diagnosed with bipolar, adhd, and anxiety; Currently taking Trileptal 675mg and lexapro 10mg. ### Response: There are many types of heart block of various degrees of seriousness. It's not possible to say from this info what you have.


Instruction: Depends on the type of block you have. Is it a first or second degree, Mobitz or Wenkebach?For a third degree, you'd've had to stay in the hospital, I guess.

Output: Or bundle branch or fascicular.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Depends on the type of block you have. Is it a first or second degree, Mobitz or Wenkebach?For a third degree, you'd've had to stay in the hospital, I guess.. ### Response: Or bundle branch or fascicular..


Instruction: I'm a 19 female, no drinks no drugs no smoke, "loose ligament syndrome"(modern day gHSD and hEDS, basically hypermobility spectrum disorders) runs down the matrilineal line. I couldn't inherit the diagnosis because diagnostic process changed, but same symptoms. Because of that, I'm very sedentary- chronic pain and bad joints makes even walking difficult to do for any extended period of time.Because of the loose ligament syndrome thing, I was supposed to have seen a cardiologist a while ago(if it's hEDS, increased risk of aortal dilation). On top of that, just learned maternal grandmother is also medicated for high cholesterol and bp, and had a heart murmur.I just scheduled a doctor's appointment for the 18th of February- just with my gp for a physical, and I'll go from there. Scheduled it after I went to an urgent care for something unrelated and they took my bpm three times(137, then 111 laying down, then 102 as they had me meditate for a minute). I have tons of symptoms that I just attributed to an autonomic condition like pots or something, and didn't bother treating because "it's not fatal"- common mentality in my family. However, these symptoms all also apply to cardiac issues. Things like chest pain spreading to shoulder blades + neck, feeling like a lump in my neck during hot shower + palpitations, blood pooling in my feet, breathlessness, dizziness, cold hands and feet, etc etc. I'm also wearing a Fitbit to help give general metrics(I know Fitbits aren't concise) to the gp.Anyways, because of these symptoms, I'm concerned that my gp will hear this and send me to the er (the gp office is connected to a hospital), rather than referring me to cardiology. These are all symptoms I've dealt with for months if not years. Not entirely afraid of that, I just like knowing what to expect and am trying to mentally map out possibilities.I'm curious to know at what point a doctor decides to refer a patient vs send them to the er? Especially if it's something the patient has been dealing with for a while(like in my case), vs something brand new?Update: nevermind had a heart event and I'm at the er now. So, fun reminder to go to the er when the internet tells you to, rather than waiting it out.

Output: As an ER doc, I can hopefully help map out the in's and out's of what "should" dictate a referral to a specialist vs. what constitutes the need for a recommendation to go to the ER.The answer is...you ready for this?...If the presentation is...an emergency. Poof. Mind blown..."You condescending asshole!" I hear you saying to yourself. But, no, seriously, this is power to you. IF your PCP, for some odd and unnecessary reason, says, "Based on your symptoms, you need to go to the ER. NOW!" Calmly tell him, or her, "But, I thought that dark and scary soul-sucking hell-hole was only for emergencies. Yet, I've had these symptoms for months. Why is this suddenly so emergent? Please just refer me to a cardiologist who can help me with my chronic cardiac issues." Then, feel free to bat your eyelashes, if you so choose, as they sit in the cesspool of being completely and totally wrecked by reason.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I'm a 19 female, no drinks no drugs no smoke, "loose ligament syndrome"(modern day gHSD and hEDS, basically hypermobility spectrum disorders) runs down the matrilineal line. I couldn't inherit the diagnosis because diagnostic process changed, but same symptoms. Because of that, I'm very sedentary- chronic pain and bad joints makes even walking difficult to do for any extended period of time.Because of the loose ligament syndrome thing, I was supposed to have seen a cardiologist a while ago(if it's hEDS, increased risk of aortal dilation). On top of that, just learned maternal grandmother is also medicated for high cholesterol and bp, and had a heart murmur.I just scheduled a doctor's appointment for the 18th of February- just with my gp for a physical, and I'll go from there. Scheduled it after I went to an urgent care for something unrelated and they took my bpm three times(137, then 111 laying down, then 102 as they had me meditate for a minute). I have tons of symptoms that I just attributed to an autonomic condition like pots or something, and didn't bother treating because "it's not fatal"- common mentality in my family. However, these symptoms all also apply to cardiac issues. Things like chest pain spreading to shoulder blades + neck, feeling like a lump in my neck during hot shower + palpitations, blood pooling in my feet, breathlessness, dizziness, cold hands and feet, etc etc. I'm also wearing a Fitbit to help give general metrics(I know Fitbits aren't concise) to the gp.Anyways, because of these symptoms, I'm concerned that my gp will hear this and send me to the er (the gp office is connected to a hospital), rather than referring me to cardiology. These are all symptoms I've dealt with for months if not years. Not entirely afraid of that, I just like knowing what to expect and am trying to mentally map out possibilities.I'm curious to know at what point a doctor decides to refer a patient vs send them to the er? Especially if it's something the patient has been dealing with for a while(like in my case), vs something brand new?Update: nevermind had a heart event and I'm at the er now. So, fun reminder to go to the er when the internet tells you to, rather than waiting it out.. ### Response: As an ER doc, I can hopefully help map out the in's and out's of what "should" dictate a referral to a specialist vs. what constitutes the need for a recommendation to go to the ER.The answer is...you ready for this?...If the presentation is...an emergency. Poof. Mind blown..."You condescending asshole!" I hear you saying to yourself. But, no, seriously, this is power to you. IF your PCP, for some odd and unnecessary reason, says, "Based on your symptoms, you need to go to the ER. NOW!" Calmly tell him, or her, "But, I thought that dark and scary soul-sucking hell-hole was only for emergencies. Yet, I've had these symptoms for months. Why is this suddenly so emergent? Please just refer me to a cardiologist who can help me with my chronic cardiac issues." Then, feel free to bat your eyelashes, if you so choose, as they sit in the cesspool of being completely and totally wrecked by reason..


Instruction: Yeah I put an update at the bottom, I'm at the ER after a cardiac event

Output: Ahhh dang. At the very least, I hope you get feeling better soon!

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yeah I put an update at the bottom, I'm at the ER after a cardiac event. ### Response: Ahhh dang. At the very least, I hope you get feeling better soon!.


Instruction: My mother has undergone an MRI brain without contract as she was suffering from double vision, major headaches, fatigue, imbalance, and frequent of coordination. The MRI scan consequently showed a small 7x4 mm nonspecific focal area of white matter high signal change seen on T2 and FLAIR sequences in the left centrum semiovale. The neurologist then advised to undergo a CT contrast scan alongside a lipid panel test to infer on the MRI findings.As per the CT scan, below were the findings:Atherosclerotic changesOcclusion of the right vertebral artery at the origin, partial visualization of the cervical segment, retrograde filling of the distal V4 segment and PICASignificant narrowing of the left PCA distal P2 and P3 segmentMild narrowing of the proximal right ICA about 40%.Right A1 segment is congenitally absent, the rest of the right ACA is hypoplasticThe lipid panel test showed the following:Lipid panel-LDL 3.34, total cholesterol 5.61Momentarily, the neurologist has requested a HBA1C and liver function exam, in addition to the echocardiogram and a 24-hour blood pressure monitoring from cardiology standpoint. He has concluded that the previous MRI reported a lesion suggestive of old ischemic infarct.I am looking for advice regarding the next viable steps as the healthcare from the country I am currently in is not up to par/adequate. I am extremely distressed and worried about this case as my father has suffered from a hemorrhagic brain stroke 12 years ago and cannot lose another parent as a result of a medical condition. I am the sole carer of both my parents who works 10 hours a day. Please advise me.

Output: It is not uncommon to have small, old infarcts as people get older.The important thing to do if these are seen is secondary prevention, meaning modifying risk factors to prevent future infarcts. This sounds like it is already taking place through the measurement of her HbA1c and lipid profile.As to whether anything is done about the existing vessel narrowing will depend on her particular case and where in the world you are and should be discussed with her team.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My mother has undergone an MRI brain without contract as she was suffering from double vision, major headaches, fatigue, imbalance, and frequent of coordination. The MRI scan consequently showed a small 7x4 mm nonspecific focal area of white matter high signal change seen on T2 and FLAIR sequences in the left centrum semiovale. The neurologist then advised to undergo a CT contrast scan alongside a lipid panel test to infer on the MRI findings.As per the CT scan, below were the findings:Atherosclerotic changesOcclusion of the right vertebral artery at the origin, partial visualization of the cervical segment, retrograde filling of the distal V4 segment and PICASignificant narrowing of the left PCA distal P2 and P3 segmentMild narrowing of the proximal right ICA about 40%.Right A1 segment is congenitally absent, the rest of the right ACA is hypoplasticThe lipid panel test showed the following:Lipid panel-LDL 3.34, total cholesterol 5.61Momentarily, the neurologist has requested a HBA1C and liver function exam, in addition to the echocardiogram and a 24-hour blood pressure monitoring from cardiology standpoint. He has concluded that the previous MRI reported a lesion suggestive of old ischemic infarct.I am looking for advice regarding the next viable steps as the healthcare from the country I am currently in is not up to par/adequate. I am extremely distressed and worried about this case as my father has suffered from a hemorrhagic brain stroke 12 years ago and cannot lose another parent as a result of a medical condition. I am the sole carer of both my parents who works 10 hours a day. Please advise me.. ### Response: It is not uncommon to have small, old infarcts as people get older.The important thing to do if these are seen is secondary prevention, meaning modifying risk factors to prevent future infarcts. This sounds like it is already taking place through the measurement of her HbA1c and lipid profile.As to whether anything is done about the existing vessel narrowing will depend on her particular case and where in the world you are and should be discussed with her team..


Instruction: Thank you for your reply. Greatly appreciated. Could I just ask in regards to the occlusion of the right vertebral artery and the 40% narrowing of the ICA - how dangerous/worrisome are those findings and should we opt for any surgical intervention?The neurologist has suggested to get her on Lipitor 20mg daily for 3 months and an anti platelet treatment (although she took aspirin before and had a huge drop in ferritin levels equating to 2.7 and edema, which led to her having to get iron infusions). The neurologist hence recommended plavix as an alternative.

Output: This will again depend on local practice and your mothers wider medical history and functional status.As an example, in my region we wouldnt consider it unless stenosis was greater than 50% and even then, the vertebral arteries are very difficult to access safely and generally only consider thrombectomy of small vessels in the acute phase.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you for your reply. Greatly appreciated. Could I just ask in regards to the occlusion of the right vertebral artery and the 40% narrowing of the ICA - how dangerous/worrisome are those findings and should we opt for any surgical intervention?The neurologist has suggested to get her on Lipitor 20mg daily for 3 months and an anti platelet treatment (although she took aspirin before and had a huge drop in ferritin levels equating to 2.7 and edema, which led to her having to get iron infusions). The neurologist hence recommended plavix as an alternative.. ### Response: This will again depend on local practice and your mothers wider medical history and functional status.As an example, in my region we wouldnt consider it unless stenosis was greater than 50% and even then, the vertebral arteries are very difficult to access safely and generally only consider thrombectomy of small vessels in the acute phase..


Instruction: In regards to medical history, my mother has been extremely healthy, no smoking or drinking, and no other medical issues. However, it is essential to note that her father and sibling have passed away from a heart attack, and two others have undergone open heart surgery.So, from my understanding, operating on the vertebral artery is extremely dangerous, and for any other stent operations regarding intracranial and extra cranial arteries, the stenosis should be larger than 50%? But what is the likelihood of her ICA percentage growing to 50% and in how long? Considering she suffered from an transient ischemic attack recently reflecting in the MRI, how would you assess this case?

Output: The number of 50% is an example of what we would use in my local practice - it does not necessarily represent the targets in your area/situation. That is a much more nuanced question that can only be answered by your team.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: In regards to medical history, my mother has been extremely healthy, no smoking or drinking, and no other medical issues. However, it is essential to note that her father and sibling have passed away from a heart attack, and two others have undergone open heart surgery.So, from my understanding, operating on the vertebral artery is extremely dangerous, and for any other stent operations regarding intracranial and extra cranial arteries, the stenosis should be larger than 50%? But what is the likelihood of her ICA percentage growing to 50% and in how long? Considering she suffered from an transient ischemic attack recently reflecting in the MRI, how would you assess this case?. ### Response: The number of 50% is an example of what we would use in my local practice - it does not necessarily represent the targets in your area/situation. That is a much more nuanced question that can only be answered by your team..


Instruction: Hello, Im posting on behalf of my 76 year old father. He had double bypass surgery back in 1995. Other chronic conditions include Afib, medically managed cholesterol, and he is a regular drinker (mainly beer and wine). His medications include Metoprolol 50 mg, Xaralto, Lipitor 40 mg, Lavazo 4000 mg, baby Aspirin, Coq10, and D3. He has dealt with very swollen feet for years and always has a dry cough. He is not short of breath or wheezy at all. In fact he is quite active, he walks about 3-4x a week, lifts with a personal trainer 2x a week, does Pilates reformer once a week, and yoga/stretching lesson once a week. He has gone to Cleveland Clinic for a full physical every year and they feel that everything is managed from a cardiology perspective. They cannot treat his Afib via electric shock for whatever physiological reason, and he doesnt want to undergo a major surgery. According to his Apple Watch, his resting heart rate is 45 for the past 13 weeks. He had a vascular doppler of his lower extremities and they found that his veins are larger than normal but no blockages. His lab work has not shown signs of kidney problems. What is most concerning to me, is that no one ever seems to be concerned about his cough. My dad is convinced its allergies but he wont take an allergy pill because it makes him tired and wont see an allergist. I would love an opinion about his very swollen feet (picture below in comment) and persistent cough. I feel like it is abnormal and we shouldnt be taking everythings fine and managed for an acceptable answer. I think that it is a symptom of something else happening in his body. What do you think it could be and do you think he should go get a second opinion? If so, where?

Output: Sounds like congestive heart failure. He should see a doctor asap.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Hello, Im posting on behalf of my 76 year old father. He had double bypass surgery back in 1995. Other chronic conditions include Afib, medically managed cholesterol, and he is a regular drinker (mainly beer and wine). His medications include Metoprolol 50 mg, Xaralto, Lipitor 40 mg, Lavazo 4000 mg, baby Aspirin, Coq10, and D3. He has dealt with very swollen feet for years and always has a dry cough. He is not short of breath or wheezy at all. In fact he is quite active, he walks about 3-4x a week, lifts with a personal trainer 2x a week, does Pilates reformer once a week, and yoga/stretching lesson once a week. He has gone to Cleveland Clinic for a full physical every year and they feel that everything is managed from a cardiology perspective. They cannot treat his Afib via electric shock for whatever physiological reason, and he doesnt want to undergo a major surgery. According to his Apple Watch, his resting heart rate is 45 for the past 13 weeks. He had a vascular doppler of his lower extremities and they found that his veins are larger than normal but no blockages. His lab work has not shown signs of kidney problems. What is most concerning to me, is that no one ever seems to be concerned about his cough. My dad is convinced its allergies but he wont take an allergy pill because it makes him tired and wont see an allergist. I would love an opinion about his very swollen feet (picture below in comment) and persistent cough. I feel like it is abnormal and we shouldnt be taking everythings fine and managed for an acceptable answer. I think that it is a symptom of something else happening in his body. What do you think it could be and do you think he should go get a second opinion? If so, where?. ### Response: Sounds like congestive heart failure. He should see a doctor asap..


Instruction: Left Ventricle: The ventricular size is normal. There is no left ventricular hypertrophy. Global LV systolic function is normal. The left ventricular ejection fraction is 70 %. LV diastolic filling parameters are c/w normal diastolic function.Right Ventricle: The right ventricular size is normal. Global RV systolic function is normal.Left Atrium: The left atrium is normal in size.Summary and Conclusions:No previous studies for comparison.Normal LV size and systolic function. LVEF= 70%. Normal LV filling pressures.Normal RV size and systolic function.Normal biatrial size.MEASUREMENTS AND CALCULATIONS:Left Ventricle: Normal Aorta/Left Atrium: Normal IVSd: 0.6 cm (0.7-1.1) LV FS: 40 % (>25%) RA Area A4C: 11.8 cm2 (<18) LV EF (Biplane) 70 %. (54-74) Right Ventricle: LV Mass 66 g (67-162) RVd A4C: 2.8 cm (2.5-4.2) LV RWT 0.40 (<0.43) TAPSE: 15 mm (>16) LV EDV 2D: 44.5 (56-155) IVC Diameter: 1.8 cm LV ESV 2D: 13.4 (19-58) LV EDV index: 31 ml/m2 (35-75) LV ESV index: 9 ml/m2 (12-30)

Output: Cardiologists take a broad approach to reading an echocardiogram, not just looking to see what measurements fall within a range. Your cardiologist is the best person to tell you if your echo is normal or not.This is a normal study

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Left Ventricle: The ventricular size is normal. There is no left ventricular hypertrophy. Global LV systolic function is normal. The left ventricular ejection fraction is 70 %. LV diastolic filling parameters are c/w normal diastolic function.Right Ventricle: The right ventricular size is normal. Global RV systolic function is normal.Left Atrium: The left atrium is normal in size.Summary and Conclusions:No previous studies for comparison.Normal LV size and systolic function. LVEF= 70%. Normal LV filling pressures.Normal RV size and systolic function.Normal biatrial size.MEASUREMENTS AND CALCULATIONS:Left Ventricle: Normal Aorta/Left Atrium: Normal IVSd: 0.6 cm (0.7-1.1) LV FS: 40 % (>25%) RA Area A4C: 11.8 cm2 (<18) LV EF (Biplane) 70 %. (54-74) Right Ventricle: LV Mass 66 g (67-162) RVd A4C: 2.8 cm (2.5-4.2) LV RWT 0.40 (<0.43) TAPSE: 15 mm (>16) LV EDV 2D: 44.5 (56-155) IVC Diameter: 1.8 cm LV ESV 2D: 13.4 (19-58) LV EDV index: 31 ml/m2 (35-75) LV ESV index: 9 ml/m2 (12-30). ### Response: Cardiologists take a broad approach to reading an echocardiogram, not just looking to see what measurements fall within a range. Your cardiologist is the best person to tell you if your echo is normal or not.This is a normal study.


Instruction: Please can I have some help identifying exactly what material has caused a nasty skin reaction in my 5 yr old? (Female, Caucasian, no health issues but has had other topical reactions in past)She had a tonsillectomy a few days ago and her skin has reacted to the sponge backing on the electrodes they stuck to her chest during surgery. (I know it's only the sponges, as the welts are in perfect circles)I've identified the electrodes as Ambu WhiteSensor 4535M https://www.ambu.co.uk/cardiology/ecg-electrodes/product/ambu-whitesensor-4535mThe data sheet says the sponge is material is "polyester polyurethane reticulated". Google tells me these are two different materials? Is there a common name for this stuff that doctors use, and is it a common medical material that I need to look out for in future?

Output: Acrylate allergy is most likely followed by nickel next.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Please can I have some help identifying exactly what material has caused a nasty skin reaction in my 5 yr old? (Female, Caucasian, no health issues but has had other topical reactions in past)She had a tonsillectomy a few days ago and her skin has reacted to the sponge backing on the electrodes they stuck to her chest during surgery. (I know it's only the sponges, as the welts are in perfect circles)I've identified the electrodes as Ambu WhiteSensor 4535M https://www.ambu.co.uk/cardiology/ecg-electrodes/product/ambu-whitesensor-4535mThe data sheet says the sponge is material is "polyester polyurethane reticulated". Google tells me these are two different materials? Is there a common name for this stuff that doctors use, and is it a common medical material that I need to look out for in future?. ### Response: Acrylate allergy is most likely followed by nickel next..


Instruction: 65M, 5'9", 140lbs, Asian / Chinese, NYC, no medications <-- My Dad's InfoI'm in a stressful medical situation right now, and need some help / advise. My dad had an emergency aortic valve and ascending aorta replacement 5 days ago due to aortic dissection 7 days ago. He was in the OR for ~11 hours because they first attempted to repair a part of the ascending aorta, took him off bypass, saw that things weren't going well, then put him back on bypass again to do a more aggressive procedure of replacing the aortic valve and the ascending aorta including the arch, so it was a very long amt of time on bypass.Yesterday he was moved from the Cardiothoracic ICU and into a normal hospital wing due to a bed shortage in the ICU. I've noticed since he came out of surgery that he has a facial muscular abnormality on his left side (his left mouth is slanted up) and is having difficulty speaking/writing (he is slow to utter syllables, is misspelling very easy English and Chinese words, can't pronounce English and Mandarin words to the point where it is not possible to have a conversation with him without both my mom and I guessing while he attempts to partially speak / write). The cardiology team told me yesterday that they don't think they need to bring neurology in to examine him because it may all be normal effects of the bypass. I am really worried there may be signs of a stroke (he can't read/write properly and his mouth is crooked) and I am wondering why nobody at my dad's hospital is concerned with a neuro eval. What do you think - should I push back more for a neuro eval or is this normal?

Output: I'm a neurosurgeon so I'm kinda talking out of turn but....I did rotate thru CT surgery as an intern long ago, so maybe it's still valid.Have they done a CT or MRI of his brain? If yes and it's normal, rest easy. A negative imaging study (especially MRI) rules out a stroke, which means there's little for neurology to do, other than diagnose "encephalopathy after surgery/bypass." However, if they've done no imaging, I'd consider that odd. My ICU has a low threshold to get a neurology consult and imaging, and someone having language issues and a facial droop for 5 days after heart surgery would certainly trigger it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 65M, 5'9", 140lbs, Asian / Chinese, NYC, no medications <-- My Dad's InfoI'm in a stressful medical situation right now, and need some help / advise. My dad had an emergency aortic valve and ascending aorta replacement 5 days ago due to aortic dissection 7 days ago. He was in the OR for ~11 hours because they first attempted to repair a part of the ascending aorta, took him off bypass, saw that things weren't going well, then put him back on bypass again to do a more aggressive procedure of replacing the aortic valve and the ascending aorta including the arch, so it was a very long amt of time on bypass.Yesterday he was moved from the Cardiothoracic ICU and into a normal hospital wing due to a bed shortage in the ICU. I've noticed since he came out of surgery that he has a facial muscular abnormality on his left side (his left mouth is slanted up) and is having difficulty speaking/writing (he is slow to utter syllables, is misspelling very easy English and Chinese words, can't pronounce English and Mandarin words to the point where it is not possible to have a conversation with him without both my mom and I guessing while he attempts to partially speak / write). The cardiology team told me yesterday that they don't think they need to bring neurology in to examine him because it may all be normal effects of the bypass. I am really worried there may be signs of a stroke (he can't read/write properly and his mouth is crooked) and I am wondering why nobody at my dad's hospital is concerned with a neuro eval. What do you think - should I push back more for a neuro eval or is this normal?. ### Response: I'm a neurosurgeon so I'm kinda talking out of turn but....I did rotate thru CT surgery as an intern long ago, so maybe it's still valid.Have they done a CT or MRI of his brain? If yes and it's normal, rest easy. A negative imaging study (especially MRI) rules out a stroke, which means there's little for neurology to do, other than diagnose "encephalopathy after surgery/bypass." However, if they've done no imaging, I'd consider that odd. My ICU has a low threshold to get a neurology consult and imaging, and someone having language issues and a facial droop for 5 days after heart surgery would certainly trigger it..


Instruction: No, they have not done imaging of the brain yet. If this were your family member, would you advocate for CT or MRI? Thank you so much for replying to me so quckly.

Output: I think a CT is a reasonable step. Quick look to rule out something concerning like a bleed or a stroke.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: No, they have not done imaging of the brain yet. If this were your family member, would you advocate for CT or MRI? Thank you so much for replying to me so quckly.. ### Response: I think a CT is a reasonable step. Quick look to rule out something concerning like a bleed or a stroke..


Instruction: Thank you so much for your help. Using info and confidence from this thread, I was able to push/advocate with the hospital over the last few days to have the surgeon finally order a CT scan and....blood clot in the frontal lobe. A stroke team then confirmed an embolic stroke immediately. He will need to have another procedure to remove fluid around the heart.It suprises me that if I had not pushed for brain imaging, my father would have been discharged as if nothing was wrong. I can see why having family/children may sometimes be the difference between good care and terrible care. It feels good to have a baseline data point and it sounds like aspirin + therapy are the only treatment that we can seek after his condition hopefully stabilizes (low blood oxygen levels, fluid in heart and lungs is in hard to reach places, etc.).The power of Reddit continues to shine. I am grateful for this community.

Output: Glad you pushed and got some answers. Heart surgery puts people at risk of both bleeding strokes (because the blood is thinned during surgery) and well as embolic strokes (because things can flick off arteries, valves, and even repair devices like aortic repair grafts). It's important to differentiate between the two, since a bleeding stroke is a contraindication to many/most post op blood thinners.I hope your dad's recovery goes smoothly. He might ultimately be a candidate for inpatient rehab, which can definitely accelerate recovery after a stroke. It's usually done at a different facility than where the surgery was done. The physical, occupational and speech therapists that work with him now will let you and the surgeon know if he's an appropriate candidate for it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you so much for your help. Using info and confidence from this thread, I was able to push/advocate with the hospital over the last few days to have the surgeon finally order a CT scan and....blood clot in the frontal lobe. A stroke team then confirmed an embolic stroke immediately. He will need to have another procedure to remove fluid around the heart.It suprises me that if I had not pushed for brain imaging, my father would have been discharged as if nothing was wrong. I can see why having family/children may sometimes be the difference between good care and terrible care. It feels good to have a baseline data point and it sounds like aspirin + therapy are the only treatment that we can seek after his condition hopefully stabilizes (low blood oxygen levels, fluid in heart and lungs is in hard to reach places, etc.).The power of Reddit continues to shine. I am grateful for this community.. ### Response: Glad you pushed and got some answers. Heart surgery puts people at risk of both bleeding strokes (because the blood is thinned during surgery) and well as embolic strokes (because things can flick off arteries, valves, and even repair devices like aortic repair grafts). It's important to differentiate between the two, since a bleeding stroke is a contraindication to many/most post op blood thinners.I hope your dad's recovery goes smoothly. He might ultimately be a candidate for inpatient rehab, which can definitely accelerate recovery after a stroke. It's usually done at a different facility than where the surgery was done. The physical, occupational and speech therapists that work with him now will let you and the surgeon know if he's an appropriate candidate for it..


Instruction: Female 35 / 55 / 195 poundsI attended my physical today and my doctor said that I have a heart murmur. This hasnt ever happened to me. She told me not to worry but now I have a cardiology appointment. I have severe health anxiety. She said its likely from anxiety or a small leak? - she said since I dont get out of breath its unlikely its serous?

Output: Everyone here will tell you the same thing your doctor told you.Take a deep breath, Relax and wait for the next appointment. No one can tell you any different without examining you.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Female 35 / 55 / 195 poundsI attended my physical today and my doctor said that I have a heart murmur. This hasnt ever happened to me. She told me not to worry but now I have a cardiology appointment. I have severe health anxiety. She said its likely from anxiety or a small leak? - she said since I dont get out of breath its unlikely its serous?. ### Response: Everyone here will tell you the same thing your doctor told you.Take a deep breath, Relax and wait for the next appointment. No one can tell you any different without examining you..


Instruction: Sex - FemaleLocation - EnglandPre-existing conditions - Chiari Malformation with Syrinx, IIHSurgeries in previous 12 months - Stents fitted to transverse sinus & ICP monitorMedications - Aspirin, Antenolol, Acetazolamide and progesterone only pill (to stop cycles, I am sterilised so not used as birth control).Issue - Hi. I am currently waiting an appointment with cardiology following a trip to A&E with tightening pains in the chest when experiencing a double heart beat. This was evident on the ECG the hospital took and appeared similar to the ones taken with my Apple Watch. It has been queried if it may be bigeminy(?). Ive attached an image in the comments from today. The episodes are becoming more frequent and happening for longer periods. I dont want to bother our already busy hospitals when these happen just to have an ECG and be sent away to wait the referral. Can anyone suggest anything I can try to stop this happening? I dont drink given my pre-existing conditions, have never smoked and Ive cut out caffeine already with no results. Thank youETA - Ive taken blood pressure when these are happening and readings are totally normal, reading with picture in comments was 114/66

Output: Looks like classic premature atrial contractions (PAC). Can happen in times of high stress. Usually benign, sometimes in the setting of new arrhythmia. Beta blockers can reduce occurrence so maybe cardiology might want to discuss atenolol dose.Sounds like you might getting into a cycle that precedes panic attacks which makes people feel like they are having a heart attack eg short of breath, chest pain. Then fear of a similar episode happening again causes stress and then you cycle right back into stress induced PACs. Breathing exercises are golden when you feel youre about to enter one of these cycles. In through the nose 4 seconds, out through the mouth for 6 seconds. Do this at least 4 times and focus on breathing.See what cardiology has to say. Very unlikely anything serious.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Sex - FemaleLocation - EnglandPre-existing conditions - Chiari Malformation with Syrinx, IIHSurgeries in previous 12 months - Stents fitted to transverse sinus & ICP monitorMedications - Aspirin, Antenolol, Acetazolamide and progesterone only pill (to stop cycles, I am sterilised so not used as birth control).Issue - Hi. I am currently waiting an appointment with cardiology following a trip to A&E with tightening pains in the chest when experiencing a double heart beat. This was evident on the ECG the hospital took and appeared similar to the ones taken with my Apple Watch. It has been queried if it may be bigeminy(?). Ive attached an image in the comments from today. The episodes are becoming more frequent and happening for longer periods. I dont want to bother our already busy hospitals when these happen just to have an ECG and be sent away to wait the referral. Can anyone suggest anything I can try to stop this happening? I dont drink given my pre-existing conditions, have never smoked and Ive cut out caffeine already with no results. Thank youETA - Ive taken blood pressure when these are happening and readings are totally normal, reading with picture in comments was 114/66. ### Response: Looks like classic premature atrial contractions (PAC). Can happen in times of high stress. Usually benign, sometimes in the setting of new arrhythmia. Beta blockers can reduce occurrence so maybe cardiology might want to discuss atenolol dose.Sounds like you might getting into a cycle that precedes panic attacks which makes people feel like they are having a heart attack eg short of breath, chest pain. Then fear of a similar episode happening again causes stress and then you cycle right back into stress induced PACs. Breathing exercises are golden when you feel youre about to enter one of these cycles. In through the nose 4 seconds, out through the mouth for 6 seconds. Do this at least 4 times and focus on breathing.See what cardiology has to say. Very unlikely anything serious..


Instruction: 22F. 115lbs. 5'2. History of gallbladder removal. History of lupus. I take aderall for ADHD and hydroxychloroquine for my lupus, as well as birth control.EDIT: Heres the full reportI saw a cardiologist a month ago and wore a heart monitor for 2 weeks and had an echo done. I went in because I have a consistently high heart. The heart monitor didn't show anything concerning according to cardiology and I was diagnosed with inappropriate sinus tachycardia. Well, I got my report back.Everything was normal besides two things that I read on the report:Trace mitral valve regurgitation.IVC is dilated at 2.5 cm.This freaks me out a bit because my doctor didn't mention any of this to me and he won't respond. On the 2D measurements, the only abnormal measurement was my LA which was 2.8 (reference range 3.0-4.0 cm).The reports from the mitral valve stated:Regurgitation: TracePeak E: 0.9 (0.6-1.3 m/s)Peak A: 0.5 (<0.7 m/s)E/A Ratio: 1.8 (0.75-1.5)The only other measurements that were high were my Pulmonic Valve:Peak Vel: 1.1 (0.6-0.9 m/s)Peak Grad: 4.5 (<=3 mmHg)I am really freaking out. How concerning is this? Is the dilation, regurgitation, and high values concerning?

Output: A lot of good answers here, I'll just confirm what the others have said. Pretty much all the answers I read are correct. It's not uncommon for our heart valves to have a tiny bit of leak (regurgitation), it's nothing to worry about. As far as the IVC. It's a touch on the large side but it could just be a normal variant. It could also mean that you are very well hydrated and there just happens to be a lot of fluid in your veins making it look nice and plump.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 22F. 115lbs. 5'2. History of gallbladder removal. History of lupus. I take aderall for ADHD and hydroxychloroquine for my lupus, as well as birth control.EDIT: Heres the full reportI saw a cardiologist a month ago and wore a heart monitor for 2 weeks and had an echo done. I went in because I have a consistently high heart. The heart monitor didn't show anything concerning according to cardiology and I was diagnosed with inappropriate sinus tachycardia. Well, I got my report back.Everything was normal besides two things that I read on the report:Trace mitral valve regurgitation.IVC is dilated at 2.5 cm.This freaks me out a bit because my doctor didn't mention any of this to me and he won't respond. On the 2D measurements, the only abnormal measurement was my LA which was 2.8 (reference range 3.0-4.0 cm).The reports from the mitral valve stated:Regurgitation: TracePeak E: 0.9 (0.6-1.3 m/s)Peak A: 0.5 (<0.7 m/s)E/A Ratio: 1.8 (0.75-1.5)The only other measurements that were high were my Pulmonic Valve:Peak Vel: 1.1 (0.6-0.9 m/s)Peak Grad: 4.5 (<=3 mmHg)I am really freaking out. How concerning is this? Is the dilation, regurgitation, and high values concerning?. ### Response: A lot of good answers here, I'll just confirm what the others have said. Pretty much all the answers I read are correct. It's not uncommon for our heart valves to have a tiny bit of leak (regurgitation), it's nothing to worry about. As far as the IVC. It's a touch on the large side but it could just be a normal variant. It could also mean that you are very well hydrated and there just happens to be a lot of fluid in your veins making it look nice and plump..


Instruction: Thank you so very much for this. It is very much appreciated. I had assumed that my doctor wouldve told me if it was concerning but I just wanted to double check. I do have very plump veins which makes blood work easy for me lol.The hydration would make sense as I hound down so much water throughout the day (close to 90 oz). I was over hydrating too much and ended up depleting my electrolytes so now I add electrolyte drops to my water.Again, thank you so much for taking the time to respond and fantastic username.

Output: I'd interpret this as basically not concerning. IVC of 2.5cm by itself can be normal in adults as long as there's good compressibility and respirophasic variation (not commented on, but given lack of tricuspid regurgitation and normal right heart function, would highly doubt any abnormalities). Most likely, this just means you were well hydrated at the time of the study.Regarding the mitral regurgitation, trace amounts of regurgitation across the mitral and tricuspid valves can occur in otherwise healthy adults without any significant pathology or cause for concern. Given that the rest of the report shows normal systolic and diastolic function, I'd be really surprised if the regurgitation they describe is significant or would cause any symptoms.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you so very much for this. It is very much appreciated. I had assumed that my doctor wouldve told me if it was concerning but I just wanted to double check. I do have very plump veins which makes blood work easy for me lol.The hydration would make sense as I hound down so much water throughout the day (close to 90 oz). I was over hydrating too much and ended up depleting my electrolytes so now I add electrolyte drops to my water.Again, thank you so much for taking the time to respond and fantastic username.. ### Response: I'd interpret this as basically not concerning. IVC of 2.5cm by itself can be normal in adults as long as there's good compressibility and respirophasic variation (not commented on, but given lack of tricuspid regurgitation and normal right heart function, would highly doubt any abnormalities). Most likely, this just means you were well hydrated at the time of the study.Regarding the mitral regurgitation, trace amounts of regurgitation across the mitral and tricuspid valves can occur in otherwise healthy adults without any significant pathology or cause for concern. Given that the rest of the report shows normal systolic and diastolic function, I'd be really surprised if the regurgitation they describe is significant or would cause any symptoms..


Instruction: My (74F) mom will likely be diagnosed with Alzheimer's later this month by the neurologist when we go for a follow-up after an inpatient stay for delirium. She is currently in a memory care facility. She has DM, OSA, and CHF with an implanted defibrillator. As I step in to manage her appointments I was wondering if she needs to see all her various specialists still. She will be seen by a Geriatrician for primary care, and I assume Cardiology would still be needed due to the defibrillator. But would she still need endocrinology and a dietician for the DM? What about Neurology and Psychiatry after the diagnosis? I got the impression from the Hospitalist that no treatment would be coming for Alzheimer's. Her DM and OSA have always been poorly controlled due to her non-compliance. I don't want her to get worse, but I'm also wanting to be as efficient as possible with the appointments since I'm on my own.

Output: When quality of life starts to decline, it is important to look at quality vs. quantity of life. If you want her to live as long as possible then yes she needs to continue to see her specialists unless they say it isn't necessary.If her goals are just peace, dignity and comfort rather than trying to extend life then focus on this instead. Her geriatrician can help with this.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My (74F) mom will likely be diagnosed with Alzheimer's later this month by the neurologist when we go for a follow-up after an inpatient stay for delirium. She is currently in a memory care facility. She has DM, OSA, and CHF with an implanted defibrillator. As I step in to manage her appointments I was wondering if she needs to see all her various specialists still. She will be seen by a Geriatrician for primary care, and I assume Cardiology would still be needed due to the defibrillator. But would she still need endocrinology and a dietician for the DM? What about Neurology and Psychiatry after the diagnosis? I got the impression from the Hospitalist that no treatment would be coming for Alzheimer's. Her DM and OSA have always been poorly controlled due to her non-compliance. I don't want her to get worse, but I'm also wanting to be as efficient as possible with the appointments since I'm on my own.. ### Response: When quality of life starts to decline, it is important to look at quality vs. quantity of life. If you want her to live as long as possible then yes she needs to continue to see her specialists unless they say it isn't necessary.If her goals are just peace, dignity and comfort rather than trying to extend life then focus on this instead. Her geriatrician can help with this..


Instruction: I have pasted the findings of my regular echo below (The tricuspid regurgitation is new) I apologize for the formatting. It wouldnt allow photos.I am a 31 y/o female and just had my yearly follow-up with cardiology. Suddenly my doctor says she is very concerned about my MVP due to my age, and scheduled the esophageal echo.Naturally, I am terrified. I have a four year old, and Im supposed to be getting married. I have issues with anesthesia and Ive been a mess at work all day at the thought of having heart surgery - or possibly not waking up.How serious DOES this sound? I believe a doctor when they say theyre concerned. But Im freaking out right now. Normal left ventricular size and systolic function with an estimated EF 55%. Mild left atrial enlargement. The mitral valve is thickened and the anterior mitral valve leaflet is elongated. There is bileaflet mitral valve prolapse and an associated eccentric jet of moderate mitral insufficiency. There is mild tricuspid valve regurgitation. Dilated IVC without respiratory variation consistent with elevated right atrial pressure 15 mmHg. Estimated PA systolic pressure at the upper limits of normal 34 mmHg. Given decline in LV systolic function (previously 65%) and technically difficult images with difficult to view mitral insufficiency, will discuss with the patient moving forward with a TEE.-Left ventricle cavity size appears normal. Left ventricular systolic function is normal with an ejection fraction of 55%.-Left atrium cavity size is mildly dilated.-Right ventricle cavity size appears normal. -Systolic function is normal.-Right atrium cavity size is normal.-The aortic valve is probably tricuspid. The leaflets exhibit normal excursion. There is no regurgitation.-The mitral valve is thickened and the anterior mitral valve leaflet is elongated. There is bileaflet mitral valve prolapse and an associated eccentric jet of moderate mitral insufficiency.-There is mild tricuspid regurgitation. RVSP is 34 mmHg.-The pulmonic valve was not well visualized.-The aortic root at the Sinuses of Valsalva appears normal in size.-The inferior vena cava demonstrates a diameter of >21 mm and collapses <50%; therefore, the right atrial pressure is estimated at 15 mmHg.-There is no pericardial effusion

Output: Sounds like the initial problem here is that they can't get good enough images of your mitral valve, so that's why the doctor is suggesting the TEE (trans-esophageal echocardiogram). This will require sedation (usually moderate sedation, like getting your wisdom teeth out). This is a very safe procedure, so I'd suggest it as a good next step to get all the important information your doctor needs.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I have pasted the findings of my regular echo below (The tricuspid regurgitation is new) I apologize for the formatting. It wouldnt allow photos.I am a 31 y/o female and just had my yearly follow-up with cardiology. Suddenly my doctor says she is very concerned about my MVP due to my age, and scheduled the esophageal echo.Naturally, I am terrified. I have a four year old, and Im supposed to be getting married. I have issues with anesthesia and Ive been a mess at work all day at the thought of having heart surgery - or possibly not waking up.How serious DOES this sound? I believe a doctor when they say theyre concerned. But Im freaking out right now. Normal left ventricular size and systolic function with an estimated EF 55%. Mild left atrial enlargement. The mitral valve is thickened and the anterior mitral valve leaflet is elongated. There is bileaflet mitral valve prolapse and an associated eccentric jet of moderate mitral insufficiency. There is mild tricuspid valve regurgitation. Dilated IVC without respiratory variation consistent with elevated right atrial pressure 15 mmHg. Estimated PA systolic pressure at the upper limits of normal 34 mmHg. Given decline in LV systolic function (previously 65%) and technically difficult images with difficult to view mitral insufficiency, will discuss with the patient moving forward with a TEE.-Left ventricle cavity size appears normal. Left ventricular systolic function is normal with an ejection fraction of 55%.-Left atrium cavity size is mildly dilated.-Right ventricle cavity size appears normal. -Systolic function is normal.-Right atrium cavity size is normal.-The aortic valve is probably tricuspid. The leaflets exhibit normal excursion. There is no regurgitation.-The mitral valve is thickened and the anterior mitral valve leaflet is elongated. There is bileaflet mitral valve prolapse and an associated eccentric jet of moderate mitral insufficiency.-There is mild tricuspid regurgitation. RVSP is 34 mmHg.-The pulmonic valve was not well visualized.-The aortic root at the Sinuses of Valsalva appears normal in size.-The inferior vena cava demonstrates a diameter of >21 mm and collapses <50%; therefore, the right atrial pressure is estimated at 15 mmHg.-There is no pericardial effusion. ### Response: Sounds like the initial problem here is that they can't get good enough images of your mitral valve, so that's why the doctor is suggesting the TEE (trans-esophageal echocardiogram). This will require sedation (usually moderate sedation, like getting your wisdom teeth out). This is a very safe procedure, so I'd suggest it as a good next step to get all the important information your doctor needs..


Instruction: 3f 3ft tall 34lbs No medications Medical history: Uncomplicated pregnancy and no complications during delivery (vaginal) VSD and heart murmur present at birth but resolved on its own and was cleared by cardiology at age 2 She does have sensory issues and possibly autism were awaiting evaluation.We play doctor a lot because going to the Dr has always been something shes had a hard time with and when I was checking her mouth I noticed she had some red dots on the inside of her cheeks. While I dont believe it to be anything worrisome I wanted to just check. I got the best pictures I could of the red dots I saw. Theres a single one on one side and about 6 on the other side. I tried asking her if anything hurt like her mouth or throat but she didnt respond and is not always able to communicate clearlyI just noticed it today, so I am unsure about the duration and how long its actually been there.

Output: Likely from normal trauma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 3f 3ft tall 34lbs No medications Medical history: Uncomplicated pregnancy and no complications during delivery (vaginal) VSD and heart murmur present at birth but resolved on its own and was cleared by cardiology at age 2 She does have sensory issues and possibly autism were awaiting evaluation.We play doctor a lot because going to the Dr has always been something shes had a hard time with and when I was checking her mouth I noticed she had some red dots on the inside of her cheeks. While I dont believe it to be anything worrisome I wanted to just check. I got the best pictures I could of the red dots I saw. Theres a single one on one side and about 6 on the other side. I tried asking her if anything hurt like her mouth or throat but she didnt respond and is not always able to communicate clearlyI just noticed it today, so I am unsure about the duration and how long its actually been there.. ### Response: Likely from normal trauma.


Instruction: 42F, obese, hypertensive but controlled on meds, normal cholesterol but low HDL, arthritis, recent ankle reconstruction (July and October), seasonal allergies, depression/anxiety.Following a bout of awful GI issues for a week in December, I developed noticeable PVCs. They have progressively gotten more frequent, so I saw my PCP in January. She referred me to cardiology following a normal CBC and MBP.I had a two-day chemical stress test and echocardiogram yesterday and today. I finished around 0900 today and by 1330 I was scheduled for an emergency heart cath tomorrow.I never spoke to the cardiologist, only his nurse. She said he was incredibly concerned about the results of my tests, but didnt elaborate. I was in shock and didnt even think to ask why he was concerned.The results were uploaded to the My Chart app and I tried to read them, but its all foreign to me.Lexiscan reportEcho reportWould anyone be willing to help me understand this?

Output: The reversible defect on the "lexiscan report" is showing that after injection of a drug to simulate the effects of exercise on your heart, there is an area of the heart that doesn't appear to be getting enough blood flow. The concern would be that there is a narrowed coronary artery in this area.These findings are not always accurate but warrant a coronary angiogram, where a small thin tube is threaded up into an artery usually in the wrist, to get a better look at the blood vessels and find if there is narrowing. If there is coronary artery disease, the options would be medical management, a cardiac stent, or recommendations for surgery.I'm reassured that you seem to have normal heart function and currently have no symptoms, and don't have diabetes which can cause some difficult-to-treat coronary lesions. "Incredibly concerned" is an unfortunate word choice, positive stress tests are a very frequent occurrence and you are stable. Don't get ahead of yourself you will know more after the cath about whether there is a problem and what to do about it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 42F, obese, hypertensive but controlled on meds, normal cholesterol but low HDL, arthritis, recent ankle reconstruction (July and October), seasonal allergies, depression/anxiety.Following a bout of awful GI issues for a week in December, I developed noticeable PVCs. They have progressively gotten more frequent, so I saw my PCP in January. She referred me to cardiology following a normal CBC and MBP.I had a two-day chemical stress test and echocardiogram yesterday and today. I finished around 0900 today and by 1330 I was scheduled for an emergency heart cath tomorrow.I never spoke to the cardiologist, only his nurse. She said he was incredibly concerned about the results of my tests, but didnt elaborate. I was in shock and didnt even think to ask why he was concerned.The results were uploaded to the My Chart app and I tried to read them, but its all foreign to me.Lexiscan reportEcho reportWould anyone be willing to help me understand this?. ### Response: The reversible defect on the "lexiscan report" is showing that after injection of a drug to simulate the effects of exercise on your heart, there is an area of the heart that doesn't appear to be getting enough blood flow. The concern would be that there is a narrowed coronary artery in this area.These findings are not always accurate but warrant a coronary angiogram, where a small thin tube is threaded up into an artery usually in the wrist, to get a better look at the blood vessels and find if there is narrowing. If there is coronary artery disease, the options would be medical management, a cardiac stent, or recommendations for surgery.I'm reassured that you seem to have normal heart function and currently have no symptoms, and don't have diabetes which can cause some difficult-to-treat coronary lesions. "Incredibly concerned" is an unfortunate word choice, positive stress tests are a very frequent occurrence and you are stable. Don't get ahead of yourself you will know more after the cath about whether there is a problem and what to do about it..


Instruction: 31M,169cm,95kgI want to ask. previously I had taken aspirin and clopidogrel as instructed by the cardiology clinic. at the same time I had an appointment with a gastroenterologist because of a stomach acid problem and the gastro doctor told me to stop Clopidogrel. When I take Aspirin and Clopidogrel Blood test like Red blood cell Hemoglobin Haematocrit is high and it was abnormal last month. My question, If I stop clopidogrel on the instructions of the gastro doctor will it cause 3 types of blood readings to increase more in the future

Output: Clopidogrel and aspirin do not affect your red blood cell or hematocrit that being said you should speak with your cardiologist before stopping those medications

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 31M,169cm,95kgI want to ask. previously I had taken aspirin and clopidogrel as instructed by the cardiology clinic. at the same time I had an appointment with a gastroenterologist because of a stomach acid problem and the gastro doctor told me to stop Clopidogrel. When I take Aspirin and Clopidogrel Blood test like Red blood cell Hemoglobin Haematocrit is high and it was abnormal last month. My question, If I stop clopidogrel on the instructions of the gastro doctor will it cause 3 types of blood readings to increase more in the future. ### Response: Clopidogrel and aspirin do not affect your red blood cell or hematocrit that being said you should speak with your cardiologist before stopping those medications.


Instruction: 40/F 5'7 175 lbs: gerd, anxiety, bile reflux, asthma, allergies. Cardiology concerns- calcium score of 149, ldl 191, total cholesterol 281, family history of heart disease at a young age.My cardiologist just prescribed Rosuvastatin 40mg. The bottle says not to take within 2 hours of magnesium or aluminum antacids. Does that include esomeprazole magnesium? I usually take all my morning medications (esomeprazole, zyrtec, fluoxetine, vitamins) together- do I need to wait 2 hrs to take the statin?

Output: No your esomeprazole should be fine

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 40/F 5'7 175 lbs: gerd, anxiety, bile reflux, asthma, allergies. Cardiology concerns- calcium score of 149, ldl 191, total cholesterol 281, family history of heart disease at a young age.My cardiologist just prescribed Rosuvastatin 40mg. The bottle says not to take within 2 hours of magnesium or aluminum antacids. Does that include esomeprazole magnesium? I usually take all my morning medications (esomeprazole, zyrtec, fluoxetine, vitamins) together- do I need to wait 2 hrs to take the statin?. ### Response: No your esomeprazole should be fine.


Instruction: My father was in his late 40s and went on a walk. He was 160 lbs and 54 and vegetarian, didnt drink or smoke, and exercised pretty regularly. He called my mom and told her he couldnt breathe. She drove to him and got there within two minutes (he wasnt too far from our house). When she got there he was unresponsive and another passerby had started cpr and called 911. He revived before the paramedics got there and was able to talk to my mom. He even called her on the way to the hospital in the ambulance and told her he got there. As soon as he got there he lost his pulse. They did cpr on him and tried to revive him for an hour before they called his death. Im very lost. How could he have been revived on the sidewalk but not in the hospital. I thought cardiac events were treatable if they were caught within the first few minutes. He had calcium deposits on his heart and had tested positive for covid two weeks prior. Any insight would be greatly appreciated as Im looking for some understanding and closure.Edit: thank you all for your comments. Ive read all of them and really appreciate the insights you all have given into what could have happened. Im talking to a doctor about getting a cardiology consult for my siblings and I to make sure there arent genetic/other issues. Im also making sure my family will get the updated covid booster shots. My dad was pretty religious and we therefore cremated him as soon as possible, because thats what he would have wanted, and tbh I value fulfilling his last wishes more than an autopsy at this time. Ive also gotten my mom and siblings into grief counseling and am looking into options myself. Thank you again for all your kind words.

Output: Hi. I am very sorry for your loss.Some cardiac arrest cases do happen in healthier individuals and can be fatal. Not all cardiac arrest cases are treatable even in an emergency.It's normal to feel lost right now, but you will get through this. Grief counseling may be helpful in your situation for closure.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My father was in his late 40s and went on a walk. He was 160 lbs and 54 and vegetarian, didnt drink or smoke, and exercised pretty regularly. He called my mom and told her he couldnt breathe. She drove to him and got there within two minutes (he wasnt too far from our house). When she got there he was unresponsive and another passerby had started cpr and called 911. He revived before the paramedics got there and was able to talk to my mom. He even called her on the way to the hospital in the ambulance and told her he got there. As soon as he got there he lost his pulse. They did cpr on him and tried to revive him for an hour before they called his death. Im very lost. How could he have been revived on the sidewalk but not in the hospital. I thought cardiac events were treatable if they were caught within the first few minutes. He had calcium deposits on his heart and had tested positive for covid two weeks prior. Any insight would be greatly appreciated as Im looking for some understanding and closure.Edit: thank you all for your comments. Ive read all of them and really appreciate the insights you all have given into what could have happened. Im talking to a doctor about getting a cardiology consult for my siblings and I to make sure there arent genetic/other issues. Im also making sure my family will get the updated covid booster shots. My dad was pretty religious and we therefore cremated him as soon as possible, because thats what he would have wanted, and tbh I value fulfilling his last wishes more than an autopsy at this time. Ive also gotten my mom and siblings into grief counseling and am looking into options myself. Thank you again for all your kind words.. ### Response: Hi. I am very sorry for your loss.Some cardiac arrest cases do happen in healthier individuals and can be fatal. Not all cardiac arrest cases are treatable even in an emergency.It's normal to feel lost right now, but you will get through this. Grief counseling may be helpful in your situation for closure..


Instruction: OP, Im NAD but my dad passed suddenly and unexpectedly from cardiac arrest 10 months ago as well. He was 66, and had received a clean bill of health from his doctor 2 weeks prior. I just want to say, I am so incredibly sorry for your loss. I know how youre feeling. Grief is such an incredibly tough journey, one that Im still in. The first few months are the hardest, I got into grief counseling immediately and talking about my dad to someone really helped me. Just know that everything youre feeling is ok, and its good to ask questions. My thoughts are with you and your family.sacca:OP, I'm NAD, but as a hospice volunteer, many hospice organizations offer grief counseling services even if the person was not involved in their hospice program. These sorts of orgainzations might be a place to start for grief counseling.Grief is different for everyone, and for many it's like a roller coaster that eventually levels out, but the ride is uncomparable to anyone elses - give yourself time and space especailly now. I lost both my parents a little suddenly (they were in their 80s, but not much warning) and for me, years later, the roller coaster has become much flatter, with more tender memories than anything else.Another person: Adding to the story chain for OP.When I was 27, I had a massive widow maker heart attack in my larger artery (LAD). I was only 27.I didn't know I had a blood clot in my heart, because I didn't know I had a clotting disorder. The LAD was 98% clotted. Sometimes there's more silent things happening in our bodies.I'm really sorry for your loss OP.

Output: Im sorry for your loss. Without an autopsy or knowing your family history its impossible to know. He could have had a pulmonary embolism or myocarditis leading to ventricular arrhythmia as a result of his COVID. He could have a genetic syndrome such as Brugada or ARVC or the like. He could have suffered a massive heart attack though thats probably least likely.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: OP, Im NAD but my dad passed suddenly and unexpectedly from cardiac arrest 10 months ago as well. He was 66, and had received a clean bill of health from his doctor 2 weeks prior. I just want to say, I am so incredibly sorry for your loss. I know how youre feeling. Grief is such an incredibly tough journey, one that Im still in. The first few months are the hardest, I got into grief counseling immediately and talking about my dad to someone really helped me. Just know that everything youre feeling is ok, and its good to ask questions. My thoughts are with you and your family.sacca:OP, I'm NAD, but as a hospice volunteer, many hospice organizations offer grief counseling services even if the person was not involved in their hospice program. These sorts of orgainzations might be a place to start for grief counseling.Grief is different for everyone, and for many it's like a roller coaster that eventually levels out, but the ride is uncomparable to anyone elses - give yourself time and space especailly now. I lost both my parents a little suddenly (they were in their 80s, but not much warning) and for me, years later, the roller coaster has become much flatter, with more tender memories than anything else.Another person: Adding to the story chain for OP.When I was 27, I had a massive widow maker heart attack in my larger artery (LAD). I was only 27.I didn't know I had a blood clot in my heart, because I didn't know I had a clotting disorder. The LAD was 98% clotted. Sometimes there's more silent things happening in our bodies.I'm really sorry for your loss OP.. ### Response: Im sorry for your loss. Without an autopsy or knowing your family history its impossible to know. He could have had a pulmonary embolism or myocarditis leading to ventricular arrhythmia as a result of his COVID. He could have a genetic syndrome such as Brugada or ARVC or the like. He could have suffered a massive heart attack though thats probably least likely..