5 weeks post PDA surgery

AP here:


Earlier in the week we went back to the cardiologist. Tonka has been sluggish and not his usual happy bouncy self. He was vomiting every so often and refusing to eat his breakfast. The bigger concern for me was that he was not interested in anything being cooked in the kitchen. His pre-surgery blood work had showed an abnormal creatinine level which can be a marker to show a kidney problem so we had a new blood panel run. Fortunately his blood work came back with everything normal so Dr. Ferguson started him on Pepcid AC twice a day. This seems to have done the trick and he is now eating with no more vomiting but he is still sluggish and with the hole in his heart fixed he should be just the opposite. Next week he will be outfitted with a cardiac holter monitor. The report generated from the monitor measures the number of PVCs (Premature Ventricular Contractions) or heartbeats that happen before the normal heartbeat, present during a 24-hour period among other data. Tonka's original heart episode was an arrhythmia which is an abnormal pattern of heartbeats either too fast or too slow. His arrhythmia was Atrial fibrillation (AF or “A-fib”). Usually, atrial fibrillation is associated with an underlying structural heart disease with severe secondary heart chamber enlargement (usually left atrial enlargement). His heart is enlarged on the left side and now that he has had the surgery to stop up the hole it should remodel back down a bit. The top chambers (the atria) get the blood from the body and lungs, and their job is to squeeze extra blood into the lower pumping chambers (the ventricles). When the atria fibrillate, the ventricle lose this extra “kick” from the atria, and this leads to less filling of the ventricles, and less forceful of a contraction. Typically the heart rate becomes extremely fast and irregular during atrial fibrillation, and patients may have heart rates above 200-220 beats-per-minute. This leads to decreased filling time for the ventricles, and even less cardiac output. Tonka’s heart rate was above 200 the day he collapsed. The readout from the monitor should be back and interpreted within a week so we will then have a better picture of what his heart is up to