[43F] Experiencing severe migraines, swollen legs and face, and heart concerns

Question

Just cause my heart didn't react to the injection does that mean i don't have chf??

Patient Description

A 43-year-old female is experiencing severe migraines that have been occurring once a week without a specific time of onset. The pain intensity is rated as a 10 on a scale of 1-10 and worsens with movement. The patient reports changes in vision and sensitivity to light, but no fever or neck stiffness. Additionally, there is significant swelling in the legs and ankles, which has been a persistent issue despite taking blood pressure medication. The patient has a history of congestive heart failure, diagnosed approximately 3 years ago, and is currently on Lisinopril (40 mg daily) and Lasix (40 mg every other day). There was mention of a nuclear injection test that did not elicit a significant reaction, but there was a noted increase in blood pressure to 151/131 initially. The patient is concerned about the severity of these symptoms and their potential impact on heart function.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions could be contributing to your symptoms:

  • Migraines: You described experiencing severe headaches that last all day and occur once a week. These headaches are accompanied by changes in vision, sensitivity to light, and nausea. Migraines are a common type of headache characterized by these symptoms.

    • Treatment for migraines often involves a combination of medications to relieve symptoms and prevent future attacks, as well as lifestyle changes to avoid triggers.
  • Congestive Heart Failure (CHF): You mentioned that you have been diagnosed with CHF. This condition can cause fluid to build up in your body, leading to swelling in your legs and ankles. It can also cause headaches due to changes in blood flow and oxygen levels.

    • Treatment for CHF typically involves medications to manage symptoms and slow the progression of the disease, as well as lifestyle changes such as a low-sodium diet and regular exercise.
  • Kidney Disease: You mentioned that your blood work often shows high BMP and creatinine levels. These are markers that can indicate kidney disease. Kidney disease can cause fluid to build up in your body, leading to swelling in your legs and ankles. It can also cause headaches due to changes in blood flow and waste removal.

    • Treatment for kidney disease typically involves medications to manage symptoms and slow the progression of the disease, as well as lifestyle changes such as a low-sodium diet and regular exercise.

What you can do

It's important that you continue to take your prescribed medications and follow your doctor's advice. Here are some additional steps you can take:

  1. Try to identify any triggers for your migraines, such as certain foods, stress, or lack of sleep, and avoid these triggers if possible.
  2. Maintain a healthy lifestyle, including a balanced diet, regular exercise, and adequate sleep, to help manage your symptoms and slow the progression of CHF and kidney disease.
  3. Monitor your blood pressure regularly and report any significant changes to your doctor.
  4. Stay hydrated and elevate your legs when possible to help reduce swelling.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe headache that comes on suddenly
  • Chest pain or discomfort
  • Difficulty breathing
  • Confusion or difficulty speaking
  • Fainting or loss of consciousness

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago

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People Also Ask


What are common triggers for migraines and how can they be avoided?

Common triggers for migraines include stress, certain foods (like aged cheese and processed meats), caffeine, alcohol, hormonal changes, and lack of sleep. Avoiding these triggers involves identifying personal triggers through a headache diary and making lifestyle adjustments to minimize exposure.


How does congestive heart failure contribute to leg and ankle swelling?

Congestive heart failure can lead to fluid retention due to the heart's reduced ability to pump blood effectively. This causes fluid to accumulate in the legs and ankles, resulting in swelling. Managing fluid intake and taking prescribed diuretics can help reduce this swelling.


What lifestyle changes can help manage congestive heart failure and kidney disease?

Lifestyle changes that can help manage congestive heart failure and kidney disease include following a low-sodium diet, engaging in regular physical activity, maintaining a healthy weight, avoiding smoking, and limiting alcohol intake. These changes can help reduce symptoms and slow disease progression.


When should someone with severe headaches seek immediate medical attention?

Immediate medical attention should be sought for severe headaches if they are sudden and intense, accompanied by symptoms like chest pain, difficulty breathing, confusion, difficulty speaking, or loss of consciousness, as these could indicate a more serious condition.


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1 Comments


Leo#3962

9 mo ago

Short answer to your question is no, a negative nuclear injection stress test cannot tell you that don't have CHF.

A nuclear stress test, also called a myocardial perfusion scan, is a test to diagnose and monitor heart blood supply to see if you have for example coronary artery disease (CAD). If your test was negative that is good news in the sense that blood perfusion of your heart is good, which means you are not at high risk for a heart attack.

Heart failure (CHF) is a different problem. It means that your heart is unable to pump blood through your body as a normal person would. This can lead to more fluid staying in your body, presenting in symptoms like your swollen ankles. CHF can be caused by diabetes, hypertension, and CAD.

Hope this helps!

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