Hi doctor,
My father has diabetes for the past 15 years and he is suffering from heart problem for the past four years. Recently he was admitted to the hospital due to severe breathing problem, sudden fainting, loss of appetite and water accumulation in the stomach and legs. After taking treatment in ICU for several days, he was discharged from hospital and was normal. But after 40 days, he was again admitted into hospital with similar symptoms. Also, laboratory tests like echo, fasting blood sugar, etc., had been done. I am attaching the medical reports. Please help.
Hi,
Welcome to icliniq.com.
After careful review, I can appreciate well the sensitivity of the issues you and your family is suffering from.
Your father seems to have left heart failure (attachment removed to protect patient identity) that landed him twice in the hospital.
He is having the valve issues, especially the mitral valve and all the related symptoms of abdominal swelling, breathing issues and leg swelling are due to failure of the heart to pump normally.
In such a case we need to go for thorough evaluation in cardiac care hospital. Try to search locally for a better heart hospital where better diagnostic test facilities available.
- The cardiologists after physical evaluation can decide if there is any need for the surgical correction of affected valves of heart.
- For other issues of the heart, he needs medications on a permanent basis to control his blood pressure, keep a minimum load on heart in terms of pumping the blood and irrigating whole body in a proper way.
- Mostly at this age and with comorbidities like diabetes mellitus, conservative management is the option for patients. His cardiologist can better prescribe heart failure medications for him out of angiotensin-converting enzyme inhibitors (ACE), beta-blockers and diuretics.
My recommended lifestyle modifications for your father include smoking cessation, restriction of alcohol consumption and salt restriction.
He is having this issue because heart muscles are unable to get their blood supply in a proper way. More specific testing like angiography may be needed for the diagnosis of the issue.
As far as the permanent management plan is concerned, it is difficult to say anything about that before assessing the heart's own blood vessels through angiography.
- We also need to see if the heart's own muscles are already irreversibly damaged due to loss of blood supply or there is a chance of reversing.
- The left ventricle is the chamber of the heart that pumps blood out of heart to irrigate the whole body. His left ventricle is working below normal having EF (ejection fraction) value of less than 35, which is indicative of poor cardiac pump function.
Probable diagnosis:
Heart failure with a reduced ejection fraction (HFrEF) or systolic heart failure (systolic HF).
Regarding follow up:For further information consult a cardiologist online.---> https://www.icliniq.com/ask-a-doctor-online/cardiologist
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