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, he has history of 12 years pneumonia repeated treatment with recent diagnosis of tuberculosis, treated by anti tuberculosis 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 breathe 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 (heart beat of 150), dyspnoea, dysphagia (unable to swallow) and more focussed 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
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 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 induced Global left ventricular hypokinesia, under transthoracic investigation demonstrated LV hypokinesia.
Discussion:
Some time 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.