, Thank you question. I will try my best to help you with your questions. I need to ask few questions before first.
answering your direct question.
yes these symptoms of mental health can be caused by severe heart failure because of poor blood supply to the brain
which effects the brain function.
Many people present with brain symptoms like confusion, disorientation, delusions
Let me know if you have questions.
Dr Ahmed, thank you prompt response. Can you give more detail about this please? Thanks Jane
The main function of heart is to supply the blood to various organs.
Once it fails which can be due to many reasons like coronary artery disease
or it can be myocarditis
or any infection
or any myopathy
which can lead to poor function of heart muscles.
this results in poor contraction of heart muscles and this lead to poor blood supply to the organs
specifically brain and kidneys
as brain relies on blood supply to get her nutritional needs
if blood flow is low this leads to accumulation of waste metabolites
which impairs the function of the brain and lead to such symptoms that i have mentioned.
You have questions ?
Thank you that it is the waste metabolites that can cause such symptoms. I am puzzled as to why the heart failure consultant did not seem to pick up that this could be the cause of his mental health problems. One assumes that if this happens fairly frequently it would be considered as on possible cause, yet the psychiatrist did not mention this possibility either. Any idea why this would be the case?
Because this occurs in around 2-3% cases
so it is likely to be missed.
I have seen cases being treated problems and years
and it turns out as heart problem
Another thing that i should mention
is that in such heart failure
there are clots in the heart which continue to embolize
and are taken to brain and various organs
this causes blockage of the brain centers and leads to such symptoms.
In such cases echo and CT scan should search in the heart
which can easily be missed.
I hope this answers your questions
Could you also advise on how such types of mental health problems are resolved please? Does it naturally resolve once the heart is functioning better/ correctly? Or is there some other treatment required? Also should I try to bring this possibility to either the heart failure or psychiatrists attention? Thank you excellent answers so fare, extremely helpful and reassuring.
Yes these can be reversed
because most of these symptoms are due to transient or partial blockage of blood supply
so when we treat heart failure
mental issues also resolve
but as you know it takes several months to recover.
Do not forget to rate my answer as excellent if no further questions, thank you.
Could you also advise regarding the concern about clots. Eco has been completed as has x ray but not sure about CT, there was talk of a scan but it wasn't undertaken. Could clots be in the brain? And should I request a brain scan? I assume clots in the heart would have been picked up on the eco? Thank you again, will definitely rate as excellent :-) So good to get direct professional answers at last.
Yes these clots can migrate from heart to brain so CT brain should be done.
Transthoracic echo only picks up 70% of clots in the heart
if these clots are in the posterior wall of heart
then they can be missed
we do either transesophageal echo
or CT scan of heart.
you are welcome.
Thank you help, I will definitely try to request a CT scan of heart and brain. Would this usually be via heart failure consultant (on NHS)?
Yes NHS can do them.
a heart expert or a cardiologist can order them
Sorry I forgot to ask are these mental health problems usually addressed by cardiologist or psychatrist? Just thinking how my OH can be helped to make sense of them in relation to heart problem, as has no insight and is determined delusions are true...
Both deal them, initially a cardiologist helps to improve the heart failure.
because it takes time brain symptoms
so till the brain recovers both cardiologist and psychiatrist have to treat
after that only cardiologist is needed.
Ok, thanks excellent information and advice, so reassuring during such a difficult time. :-)