### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
60yo male history of atrial fib with 2 strokes from them does not take his medications..now sleeping more than half the day..falling down at times no slurring of words but seems to be getting much weaker has severe cramping in legs and chest at times...is this from the atrial fib and what can i do for him ..he was in hospital last year for 1 week to get his blood thinned out took the meds for 1 month then quit hasnt been back to dr since

### output:

Hello Thanks for posting at Chat Doctor. Atrial fibrillation means irregular contractions of the heart. Due to irregular contractions of the heart, clots tend to form in the heart which may later go towards the brain and other organs leading to stroke. Hence, such patients are kept on blood thinners which prevent the clots from forming. These clots when they migrate to the brain can cause falls. Also since the heart rate is irregular, the heart may not receive blood supply for short intervals which can also lead to falls. As you said he has stopped hid blood thinner medications, this may be due to formation of clots. Cramping in the legs is less likely due to clots or blood thinners, but some heart patients are on diuretic medications like lasix which can cause electrolyte imbalance and result in cramps. Kidney problems can also lead to electrolyte imbalance and cramps. Calcium deficiency, It D deficiency are also important causes of cramps. Please do an ECG, serum electrolyte levels, serum calcium, It D add 2 D Echo. Brain imaging (MRI + MRA) and carotid (neck artery) Doppler should also be done to rule out narrowing of the vessels of the neck and the head which may cause falls. Wishing you good healthRegards