Case Discussion

vein refluence disfunction   Posted By linda Ye    Date : 10-Aug-01   03:05 AM     Reply

Dear friends : I need your wisdom and experience to help me solve this problem, please give me your advice. This is a 64 years old male. He had a cerebral infarction at right temporal and fundus on Oct 12, 2000. Two weeks late, he accepted a VVI pace (Biotronic ) implantation through right cephalic vein because of sick sinus syndrome (BTS). Forty days after his cerebral attack, he was discharged with only a little numb feeling left on his left leg. During the first 2-3 months after discharge, he had a little edema on lower legs which disappeared with digoxin and diuretic. But since the fourth month till now (altogether 5 months)he have showed a gradually aggravated vein refluence disfunction on both legs and arms, with most severe in right arm and lightest in left arm. Now, as soon as he stands up, red even purple with a little swollen shows from his feet to upper legs, from his finger to lower arms. But once he lies down, all the signs disappeared in a second. He have tried 10 days warfarin, 5 mg per day, but didn't get better. He has no history of hypertension, diabetics or valvular heart disease, with good heart function (EF=67%).No smoking or alcohol addiction. Have anyone dealt with similar patient before? Could anyone explain why and tell me how to solve the problem please? I expect your advice and thanks in advance.

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