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Dr .Saeed ahmed
Dr .Saeed ahmed, Doctor
Category: Cardiology
Satisfied Customers: 4470
Experience:  MBBS/FCPS(R)/MRCP U.K(R), Senior Registrar Cardiology
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My other half has been having mental health problems

Resolved Question:

My other half has been having mental health problems months, persacutory and grandiose delusions mainly, at the same time they started (and few months before more mildly) my OH also began experiencing physical symptoms (excessive sweating, loss of appetite, urge to pee frequently, chesty cough, progressing to severe oedema) which recently culminated in a diagnosis of severe heart failure (level 4) and hospitalisation. My question is could the mental health problems (delusions) be a symptom of or be caused by the severe heart failure?
Submitted: 2 years ago.
Category: Cardiology
Expert:  Dr .Saeed ahmed replied 2 years ago.
Dr .Saeed ahmed :

, Thank you question. I will try my best to help you with your questions. I need to ask few questions before first.

Dr .Saeed ahmed :

answering your direct question.

Dr .Saeed ahmed :

yes these symptoms of mental health can be caused by severe heart failure because of poor blood supply to the brain

Dr .Saeed ahmed :

which effects the brain function.

Dr .Saeed ahmed :

Many people present with brain symptoms like confusion, disorientation, delusions

Dr .Saeed ahmed :

Let me know if you have questions.

Customer:

Dr Ahmed, thank you prompt response. Can you give more detail about this please? Thanks Jane

Dr .Saeed ahmed :

Yes Jane,

Dr .Saeed ahmed :

The main function of heart is to supply the blood to various organs.

Dr .Saeed ahmed :

Once it fails which can be due to many reasons like coronary artery disease

Dr .Saeed ahmed :

or it can be myocarditis

Dr .Saeed ahmed :

or any infection

Dr .Saeed ahmed :

or any myopathy

Dr .Saeed ahmed :

which can lead to poor function of heart muscles.

Dr .Saeed ahmed :

this results in poor contraction of heart muscles and this lead to poor blood supply to the organs

Dr .Saeed ahmed :

specifically brain and kidneys

Dr .Saeed ahmed :

also lungs

Dr .Saeed ahmed :

as brain relies on blood supply to get her nutritional needs

Dr .Saeed ahmed :

if blood flow is low this leads to accumulation of waste metabolites

Dr .Saeed ahmed :

which impairs the function of the brain and lead to such symptoms that i have mentioned.

Dr .Saeed ahmed :

You have questions ?

Customer:

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?

Dr .Saeed ahmed :

Because this occurs in around 2-3% cases

Dr .Saeed ahmed :

so it is likely to be missed.

Dr .Saeed ahmed :

I have seen cases being treated problems and years

Dr .Saeed ahmed :

and it turns out as heart problem

Dr .Saeed ahmed :

Another thing that i should mention

Dr .Saeed ahmed :

is that in such heart failure

Dr .Saeed ahmed :

there are clots in the heart which continue to embolize

Dr .Saeed ahmed :

and are taken to brain and various organs

Dr .Saeed ahmed :

this causes blockage of the brain centers and leads to such symptoms.

Dr .Saeed ahmed :

In such cases echo and CT scan should search in the heart

Dr .Saeed ahmed :

which can easily be missed.

Dr .Saeed ahmed :

I hope this answers your questions

Dr .Saeed ahmed :

Let me know if you have questions.

Customer:

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.

Dr .Saeed ahmed :

Yes these can be reversed

Dr .Saeed ahmed :

because most of these symptoms are due to transient or partial blockage of blood supply

Dr .Saeed ahmed :

so when we treat heart failure

Dr .Saeed ahmed :

mental issues also resolve

Dr .Saeed ahmed :

but as you know it takes several months to recover.

Dr .Saeed ahmed :

Do not forget to rate my answer as excellent if no further questions, thank you.

Customer:

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.

Dr .Saeed ahmed :

Yes these clots can migrate from heart to brain so CT brain should be done.

Dr .Saeed ahmed :

Transthoracic echo only picks up 70% of clots in the heart

Dr .Saeed ahmed :

if these clots are in the posterior wall of heart

Dr .Saeed ahmed :

then they can be missed

Dr .Saeed ahmed :

we do either transesophageal echo

Dr .Saeed ahmed :

or CT scan of heart.

Dr .Saeed ahmed :

you are welcome.

Customer:

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)?

Dr .Saeed ahmed :

Yes NHS can do them.

Dr .Saeed ahmed :

a heart expert or a cardiologist can order them

Customer:

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...

Dr .Saeed ahmed :

Both deal them, initially a cardiologist helps to improve the heart failure.

Dr .Saeed ahmed :

because it takes time brain symptoms

Dr .Saeed ahmed :

to recover

Dr .Saeed ahmed :

so till the brain recovers both cardiologist and psychiatrist have to treat

Dr .Saeed ahmed :

after that only cardiologist is needed.

Customer:

Ok, thanks excellent information and advice, so reassuring during such a difficult time. :-)

Dr .Saeed ahmed :

you are welcome.

Customer:

Thank you!

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