Niraj Khatri Sapkota
Chitwan Medical College, Nepal
Title: A case of undiagnosed global LV hypokinesia in pneumonic patient
Biography
Biography: Niraj Khatri Sapkota
Abstract
Case Report: Patient of age 20 years old visited medicine OPD complaining of dyspnoea and dysphagia, diaphoresis with sign of, tachypnea (21 breathe per minute)and tachycardia of 150 btm with blood pressure 90/60 mm of Hg, he has history of 12 years pneumonia repeated treatment with recent diagnosis of tuberculosis, treated by antituberculosis medication before 6 months, his weight was 25 kg at the moment of visit, in his previous visit to different clinician, suspected to have cancer due to his reduced weight indication, due to dyspnoea symptoms, prescribed asthmatic medication which he undergone for 15 days for example salmeterol, ipratropium, emsolone, fluticasone before the visit to our OPD, during this course of medication his shortness of breath exacerbated and along with difficulty in swallowing hence he forced to come to visit us. During our OPD visit of his examination - He was suspected to suffer from multiple organ problem due to demonstrated symptomatic status like as tachycardia (heartbeat of 150), dyspnoea, dysphagia (unable to swallow) and more focused symptom was critical reduction in weight 25 kg in 10 years of time, hence he was referred to Cardiology department, for further examination expecting that there must be involved of cardiac problem if not we will rule out it. On visit to cardiology department, Echo test was said to perform, not performed till his this age of 20 years, before visit to us. Test performed for the diagnosis in our Hospital, Blood test, LFT, ECG, ECHO. Test Result: Upon admission at our institution, Chitwan Medical College Teaching 1, Nepal. He denied angina or recent heart failure symptoms. He underwent transthoracic echocardiography that revealed an EF of 36% with severe global left ventricular (LV) hypokinesia. His echo impression revealed Global LV hypokinesia. On the basis of echo test result he was prescribed spironolactone, metoprolol,and one antibiotic to prevent from infection improve and strengthens the muscle of heart so that his prognosis of symptoms be amended in assumption to remodel the cardiac system and to enhance easier life survivality. Conclusion: This is clear undiagnosed case of long term pneumonia treared Global left ventricular hypokinesia, Discussion: Sometime physician and clinician only concentrate on the symptomatic feature focussed to that organ problem, and they get confused on the exact organ failure or association of the concerned part that leds to undiagnosed the case and finally worst outcome, finally death. Diagnosed diabetes by Debix, a proprietary Ayurvedic or in alternative medicine manufactured by Sandu pharmaceutical Pvt.Ltd without any report of side effects under continuous supervision, at least for four months to fully manage the case.
Recent Publications :
1. Sapkota NK (2017). Effect of phototherapy in ionized Magnesium and bilirubin level in hyperbilirubinmic neonates. Innovare Journal of Medical Sciences. 5(1):10-11.
2. Sapkota NK (2017).Pre-hypertension independent deleterious effect in body system. Innovare journal of Medical Sciences. 2(4):1-2.
3. Sapkota NK, Swain KC (2017). Obesity, type 2 Diabetes mellitus and its management. Innovare Journal of Health Sciences. 5(1):17-20.
4. Ram Lochan Yadav, Khadka R , Agrawal K, Thakur D, Sharma D, Shah DK, Yadav PK, Sapkota NK, et al(2016). Analysis of cardiac autonomic modulation in normotensive obese and eutrophic adults of Nepal. International journal of research in Medical Sciences.4 (1):105-110.
5. Sharma D, Paudel BH, Khadka R, Thakur D , Sapkota NK et al (2015). Time domain and frequency domain analysis of heart rate variability in elite Nepalese football players. International Journal of Biomedical Research.6(09): 641-646