Struggling with fitness on Warfarin or due to surgery

[jonno207]

Hi

I had an Aortic heart valve replacement surgery in July 2018 and have been on Warfarin ever since. I have my INR regularly checked and it's normally within 2-3 which is my target range, apart from one episode where it shot up to 14!! After a week in hospital and having excess fluid drained from around my heart and reducing my LFT from nearly 1000, my INR has always been within range.

18 months after my surgery though I still haven't regained any fitness, before the op i regularly played football and went running etc, now I struggle to go up a flight of stairs without getting out of breathless and feeling dizzy. I have tried to resume my sporting activities and build up my fitness but I really struggle and was wondering if it was the warfarin or if anyone else has had this problem.

Thanks for any feedback.

[Fortepiano]

Warfarin wouldn't affect your exercise. Have you checked you are not anaemic?

Did you do cardiac rehab after your surgery? How long ago was your hospital stay? That could well have knocked you back.

If you feel you are not improving do go back to your doctor. I had setbacks which held me back but at 18 months after my AVR I was pretty good.

All the best

[jonno207 in reply to Fortepiano]

Thanks for the reply.

I spent 5 days in hospital, left and that was that. I had one follow up with my surgeon 2 months later where i had an x-ray and I saw my cardiologist about 9 months later and they found quite a lot of fluid around my heart which resulted in me been in hospital for a few days having it drained. Every time I query why I'm feeling a certain way I just get fobbed off with its normal and the healing takes time. My chest still hurts every time I cough or sneeze but the x-ray I had shows that the breast bone is fully healed.

I just don't feel myself at all but there doesn't seem to be an obvious explanation.

[Shar28]

Hello, my husband had his AVR 2 years ago and is on Warfarin too. He has Dilated Cardiomyopathy. He has regained a lot of his fitness post-surgery gradually building up his exercise but not to the level of before his condition developed. As Fortepiano says, Warfarin doesn’t affect your fitness.

When did you last see your Cardiologist and what did they say? If you’re due for a review it may be worth chasing it up via the Consultant’s secretary otherwise I’d suggest discussing your symptoms with your GP and see what they say.

All the best. X

[jonno207 in reply to Shar28]

Thanks for the reply.

I last saw my cardiologist just before Easter last year and there was quite a lot of fluid around the heart, he didn't seem concerned about this but about 3 weeks later I collapsed and was taken to hospital were it was drained. My INR had shot up to 14 even though I was told to stop taking it for a few days as it was slowly rising and my LFT (Liver Function Test) was sky high at around 900. They think it may have been drug induced hepatitis as my body wasn't breaking down the warfarin for what ever reason. Nothing more has been said or done about the fluid that was round my heart since then and they've never checked to see if it's returned, even though I have asked several times for an echocardiogram.

I just feel that far worse than I did before my valve replacement, although I wasn't showing any signs or symptoms of a leaking valve and it was found by pure luck due to a routine blood pressure check before an injection. I think it's time to be a bit more direct and ask to see my cardiologists and not get fobbed off with excuses.

[Shar28 in reply to jonno207]

Hi. Having a full review with your consultant sounds good to me. Perhaps phone the BHF nurses first as they might be able to suggest exactly what questions to ask and what data it would be useful to gather beforehand so you’re going with objective evidence about your condition. For example, BP, activity levels and the affect that activity has on you, sleeping lying down or proposed up etc.

BHF number is 0300 330 3311, weekday office hours. They’re fantastic in our experience.