Dr. Irwin M. Best

Perhaps Yes,

However, it is important to have a professional evaluate your varicose veins to determine your treatment options and make an appropriate recommendation.

Thanks for this very interesting question. A murmur is the result of non laminar blood flow like water flowing over a stone in a stream. Murmur during the contracting phase of the heart might be caused by obstruction to flow out of the heart or flow across a poorly closed intracardiac valve - ejection or regurgitation murmurs. These are just a few of the important concerns in evaluating heart ️ murmurs! Your anesthesiologist will definitely want to know what type of murmur you have and if anesthesia will worsen your heart function. You did not mention what kind of surgery or anesthesia that is being considered, nor did you mention any type of clinical symptoms that might foretell difficult with general anesthesia! Fortunately, there are non-invasive painless tests - echocardiography - that can readily evaluate cardiac murmurs and function with a high degree of accuracy. Please talk with your medical team so that they can perform a proper medical evaluation and specific diagnostic test.
Again, thanks for this interesting question. I hope that it points you in the right direction.

Irwin M. Best, MD, MBA,FACS

Thanks for this interesting question. The duration of heart surgery is determined by the type and complexity of the specific heart ️problem that is being fixed. For example, blockages to heart arteries, heart valves, aneurysms, or a combination of all of these! Some blockages of heart arteries can be fixed by catheters alone! Similarly, some value problems with values can also be fixed by catheters.

Moreover, the duration of the procedure and the recovery period is directly related to the complexity of the procedure and the pre-operative condition of the patient. Obviously, the experience of the treatment team is invaluable in this assessment. Consequently, these considerations should be discussed directly with the treatment team after a complete assessment of all the clinical information.
I hope that this gives you some points to discuss with your treatment team.

Irwin M. Best, MD, MBA,FACS

Thanks for this very important question! What happens to the heart after a heart attack? Does part of the heart die?
Terminology:

-Heart attack
-Myocardial infarction
-A coronary
-Angina

All point to poor blood supply to the heart. The heart is a pump. Without fuel (BLOOD supply) it can stop! Cardiac arrest! Then the whole body stops working! When a small part of the heart's blood supply is blocked, that part of the heart might die and become scar tissue, provided it does not cause additional problems with heart functioning! It is very complicated! Never try to sort this out by yourself! If you think you are having a heart attack, call 911. Please don’t drive yourself! Get to a hospital. They have the expertise to sort this out! If you get there in time, the blocked arteries can be cleared before the heart muscle dies.

You did not ask about STROKE, brain infarction/attack, but the same is true! Call 911! No time for self diagnosis!! These are for the experts! Don’t waste time!

Something not right? Don’t try to figure it out Call the expert - 911.
Hope this helps.

Irwin M. Best, MD, MBA,FACS

Treatment?
This would depend on several factors?
Fast or slow rate?
Symptoms or not?
Nature or the rate/rhythm disturbances.
Yes if you are having symptoms you should call EMS and get medical attention. Please do not drive yourself since this can result in accidents if your condition becomes worse... fainting, dizziness...
If totally fine, call your Medical Doctor for an initial evaluation and lab work!
Hopefully this points you in the right direction.
Thanks.

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Irwin M Best, MD, MBA,FACS
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Might I ask you to consider this question: How dangerous is crossing the street? Similarly, leg DVT can be innocuous or DEADLY:

-More clot in the leg can damage the leg...
-Pain, swelling, discoloration, gangrene
-Or clot breaks away an travel to the lungs causing:

-Shortness of breath
-Rapid heart rate
-Death!

What is your specific risk for these events? You must seek the attention of a vascular specialist to help to:

-Assess your risk
-Lower your risk for planned surgery
-Monitor you for several months after and treat with medications if warranted by your specific risk profile!

I trust that this helps you to understand your specific situation and to seek the appropriate Professional evaluation and management of your situation.

Irwin M. Best, MD, MBA,FACS

What can happen if varicose veins are left untreated?

1. Nothing
2. Enlargement
3. Edema - swelling
4. Pain/soreness/ aching
5. Discoloration
6. Inflammation
7. Thrombosis
7. Ulceration
8. Bleeding
9. Cancer - very rarely

Therefore, evaluation by a vascular specialist is essential.

Irwin M Best, MD, MBA,FACS

How are blood clots in the veins diagnosed?

1) At autopsy by a medical examiner as an incidental finding or actual cause of death.

2) By signs and symptoms at home (leg pain, swelling, discoloration).

3) By sudden chest pain and shortness of breath, from pulmonary embolism (clots swimming from the legs to the lungs).

4) By sudden abdominal pain from thrombosis of the veins in the abdomen.

5) Confirmation of DVT by Duplex ultrasounds - the workhorse for DVT evolution! Limited in pelvis, chests, and abdomen!

IPG... older not used much
CT - venous study - Head, chest & abdomen
MRV - all areas of the body!

Subclinical DVT might be diagnosed incidentally during exams for other problems! A family history of DVT does not warrant prophylaxis unless put into a situation that promotes DVT.
Your doctor can best evaluate and advise for these risks.

Irwin M. Best, MD, MBA,FACS

Angio - vessel
Plasty - molding, repair

Therefore, the term is not particularly specific.
A vessel - artery or vein will be repaired
- Molded by a balloon angioplasty
- Widened with a patch - patch angioplasty

If angioplasty fails, a stent can be used to fix the defect in the blood vessel.

A vascular surgeons is a physician who diagnoses and manages diseases is veins, arteries, and lymphatic occurring anywhere in the body except for the heart

All treatments have failures rates. Fortunately, this one is very low (~5%). Varicosities might occur in different veins over time . However all the veins should be examined before treatment of then Saphenous veins.

Knee-high vs thigh-high stockings? Excellent question!

Patients find knee-highs easier to put on in the morning and easier to wear during the day. Therefore, I order both types since some compression is better than NONE.

A careful Duplex Ultrasound examination of the veins in the legs would indicate which stocking type is ideal.