What causes loose motions and breathing issues with an EF of 18 %?

Question

Hi,

My brother has been suffering from loose motions for the last four days, and all of a sudden, today, he felt uneasy breathing. We went to the hospital, and they suggested a 2D echo. Doctors found the EF to be 18 %, and it is dangerous. We are consulting online for a second opinion. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. Most probably, he has myocarditis. It is confirmed on cardiac MRI (magnetic resonance imaging) or biopsy. A biopsy is rarely done, as an MRI can easily diagnose it. He should take medicines to increase his urine output and to prevent further deterioration of cardiac function.

I suggest you give him the following tablet of Furosemide 40 mg once or twice a day depending upon congestive symptoms, a tablet of Sacubitril with Valsartan 24 mg or 26 mg twice a day, and a tablet of Empagliflozin 10 mg once a day. Get serum potassium levels done. If it is less than 5, give him a tablet of Spironolactone 25 mg once a day. If no congestive symptoms are present, then there is no need for Furosemide; instead, you can add a tablet of a beta blocker Carvedilol 6.25 mg twice a day.

Get an electrocardiogram (ECG) done and send me the reports. Consult with a specialist doctor, talk with him or her, and take medicines with their consent. His creatinine level is also raised. The underlying cause should be detected. Hemoglobin level is also low. So, I suggest you get an ultrasound KUB (which includes the kidneys, ureters, and urinary bladder) done. Does he or anyone in the family have diabetes, hypertension, or a history of heart failure?

I hope this helps.

Please revert so I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern.

Simple renal cysts do not affect kidney function. Excessive diarrhea may cause renal dysfunction. Heart failure can also cause kidney dysfunction. If it is a well-equipped ICU (intensive care unit), it is fine. They have cardiologists as well. If blood pressure is 180, it is very high. Therefore, IV (intravenous) nitrates should be given to lower it. Other medicines which I suggested should also be given. Exact medicines depend upon signs and symptoms of heart failure and the patient's metabolic panel. Send his ECG also.

I hope this helps.

Please revert so I can assist you further.

Thank you.