There is breathing issue in a cardiac patient. Please help.

Hello,

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I have gone through the reports (attachment removed to protect patient identity). The likely cause for his shortness of breath is heart failure only. However, the infection, high BP may precipitate this heart failure and leads to accumulation of fluid within lungs and shortness of breath. Also, elevated blood sugar is an incidental finding and will come to know on the blood test and will not cause shortness of breath directly. So, the infection may precipitate heart failure in susceptible patients. So, both infection and heart failure needs to be treated. For infection, he needs to be on antibiotics and for heart failure, he has to be on multiple medications including medicines which will increase urination. So, in the treatment chart which you have attached, the diuretics and beta blockers which are two important medicines in his case are not there, so need to discuss with the local doctor regarding these if not having. Also, antibiotic for infection is not mentioned so discuss regarding this if course is not completed. Next thing, he should have an echo done to look for heart function if not done recently. He needs to have cardiologist consultation for assessment for angiography after his shortness of breath is resolved and an optimization of medicines. So, overall, the treatment he is having is fine but he will need some more medicines for heart failure or ECG abnormalities and will need an echo.

Hi,

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So Kephazon and Daclinex are antibiotics and infection part is taken care off. But, Lasix has to be continued on long-term in order to prevent further heart failure attacks. This will remove excessive fluid out of the body. He should have low salt and less of water and fluids in a day to prevent such heart failure episodes. Next thing, he is not on beta blockers like Metoprolol for his heart failure and ECG abnormalities, so needs to be started on this. Echo is absolutely necessary and he will likely need an angiography as well after the echo. So visit the nearby cardiologist for all these.

Hello,

Welcome back to icliniq.com.

I have gone through the reports. The striking is his ejection fraction, which is 35 percent, meaning his heart is not functioning fully and this dysfunction leads to accumulation of fluid and shortness of breath. Shortness of breath will likely recur as he is not on diuretics medicine like Lasilactone or Dytor Plus. So, he must be started on this to reduce the risk of heart failure. Inhalers will not work in this type of shortness of breath, only precaution at home is low salt and fluid diet. Also, beta blockers like Metoprolol is must to prevent further decline in heart function. Also, he will need an angiography and may need angioplasty as he is likely to have blockages in his heart.

Hi,

Welcome back to icliniq.com.

He has to be started on Dytor plus and Metoprolol, but dosage depends on his examination findings like pulse rate, BP, and other examination findings. So, it is better to get it started from the local doctor after examination rather than prescribing it here. So, if he stays on these medicines, chances of repeated heart failure decreases significantly. Considering his heart function, he must be under local cardiologist follow up.