restrictive cardiomyopathy

Bipin K. Pillai pillai at elm.egr.uh.edu
Mon Apr 15 18:10:48 EST 1996


Hi !! 
Please excuse me if this is not the right place for posting such articles.  
Any suggestions of where i could post such an article would be  
appreciated.


I am posting this for a friend's friend's friend's brother (I am serious).
He is suffering from cardic problem, his heart's elasticity is reduced,  
which makes it difficult to pump blood. Doctor have given up hope. He is  
lying in intensive care unit. 

I was sent the following synopsis:

Dr. Ashok H. Punjabi (CARDIOLOGIST)
DISCHARGE SUMMARY

NAME: MR SUSHIL JAIN		AGE: 48 YEARS	SEX:MALE


Date Of Admission:1.26.96		Date Of Discharge:2.4.96

SUMMARY
	Mr. Sushil Jain, a 48 year old male, and diagnosed case of  
restrictive cardiomyopathy has been admitted with c/o giddiness and  
syncopal attacks - 2 hours prior to admission and vomiting the previous  
day. There was h/o fever,seizures or oliguria. There was no chest pain.

	On admission, he was conscious, alert with pulse of 96/min and BP  
of 70 mm Hg systolic. The JVP was raised and there was marked oedema feet.  
Systemic examination revealed hepatomegaly and free fluid in the abdomen.  
The scope showed runs of broad QRS tachycardia. (? ventricular  
tachycardia, ? SVT with aberrant conduction) which responded to IV bolus  
Xylocard.

         1.26.96  1.27.96  1.28.96  1.29.96  1.31.96
BUN        21       33		  
S.Creat	  1.9      2.6       2.2     0.9       0.8
Na	  124      123	     122     133		   
K         7.5      6.6       4.4     3.9       4.8
Cl        95        92	     87	     96
TCO2	 14.4     17.6      20.2	
SGO2	  798
Bili T     3
D         2.4

	In view of hyperkalemia and azoremia nephrology, opinion by Dr.  
Hemant Metha was taken and he was treated with glucose insulin drip, Kay  
Exalate powder, Lasix, Sodabicarb, Calcium gluconate and Sporidex. His  
urine output gradually improved and the azotemia settled down.

	During the stay, he develpoed constipation which did not respond  
to Laxatives or simple enema. Dr. Anand Nande (Consultant surgeon) did  
manual removal of faeces and the patient improved thereafter with neotomic  
enema.

	He was discharged on following medication on 2.4.96 :

	TABLET ANTIDEP 25 mg O---O---1
	TABLET SUPRADYN 1 OD
	TABLET LASIX 40 mg 1--O---O
	SYRUP CREMAFFIN 2 TSP AT BED TIME.

Patient develops similar symptoms on 4.10.96 and admitted to hospital in  
ICU again on same day.

Has anyone handled a similar case/situation. Any assistance (suggestions)  
regarding this would be deeply appreciated. You can send the mail to   
BCSSADM0 at giasbm01.vsnl.net.in or  blips at uh.edu.

Thanks.
Bipin Pillai



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