Hi doctor, My father is 67 years old. His past history included pneumonia several years ago, leg cramps once in every two weeks or so and vitamin B helps with it and minor daily coughing of unsure cause. He never smoked and does not drink alcohol. Three and a half weeks ago, he went to the ER due to severe chest pain. His EKG was apparently unconcerned, chest x-ray was clear, CT scan of the chest was normal and all the laboratory tests were normal. He was given Morphine and Nitro and the chest pain got resolved. He was sent home the same night with Nitro prescription and an appointment to see a cardiologist. He saw cardiologist one and a half weeks ago. His cardiologist said that his EKG reveals AFib and not happy with a CT scan of the chest due to poor timing of filming versus contrast injection. He placed him on Diltiazem, Eliquis and Nitro prn. Also, he placed him on a cardiac monitor at home and given a follow up in two weeks.After the cardiologist appointment, my dad started getting a horrible dry, hacking cough, which gets worse every day. He is unable to sleep. He can only sleep on the chair here and there. Strangely, when he lies down, the cough subsides. It resumes immediately on sitting up and walking around. I finally convinced him to call the cardiologist about severe unrelenting cough since being put on new medicines. Then, we met the cardiologist and had a heart monitor read. As the cough still persists, chest x-ray was ordered and no pneumonia, but fluid was found around his heart. So, the cardiologist has placed him additionally on Digoxin, Lasix and Potassium along with Cardizem, Eliquis and Nitro prn. He is asked to wear monitor longer and given next appointment after three weeks.Now, he is on the third day of medication and no change was observed in cough or inability to sleep. It even got worse now. He has never had heart issues before. I need your help on my father's cardiac illness and diagnosis.
Hi. It is good to hear that you are concerned and participating in treating your father's health issues. From your description, it looks like he has congestive heart failure. It means the fluid around his heart is causing the Atrial fibrillation and the cough. This is typical when lying down, since the position of the heart changes then. My advice is to consult your cardiologist to revise the dosage of Lasix (Furosemide). Furosemide is the only medicine that will help the water to clear out, it also might cause a bit of the cough, which was the reason for changing of the medicines by the cardiologist initially, due to the side effects of cough. I understand your concern, but according to me, the treatment is fine, except maybe he might now need a higher dose of Lasix or admission to get the Lasix IV administration. For further doubts consult a cardiologist online -->