Mar 2011|Vol 8|Issue 3
   
 
Case
 
   

A Case of Congestive Cardiac Failure

 

 

A case of congestive cardiac failure, treated successfully in the Inpatient department of National Institute of Homoeopathy under Dr. Subhash Chaudhary, Lecturer and his team is presented here. He can be contacted at Dr. Subhash Chaudhary, MD (Hom.),National Institute of Homoeopathy (Govt. of India),Block GE, Sector III, Salt Lake,Kolkata, West Bengal - 700106, India,Mobile No. +91-9748998569, Email: drsubhashmd@yahoo.com

 
 
 

     A case of congestive cardiac failure, treated successfully in the Inpatient department of National Institute of Homoeopathy under Dr. Subhash Chaudhary, Lecturer and his team is presented here.

·An old male aged 70, Muslim, resident of a rural area near Kolkata, was admitted to NIH hospital and he presented with
1. Progressive severe breathlessness for 3 months.
2. Swelling of dependent parts (lower limbs) for 20 days.
3. Associated with fatigue, tiredness and palpitation.

History of present complaint:
   From about 3 months patient has been developing severe breathlessness < lying down+++, talking++, on slight exertion, 4 am. > in open air, bending forward, desire for fanning. Swelling of lower limb, which increases most prominently in evening. Previously he took allopathic treatment; but he developed medicinal intolerance. Associated fatigue feeling and sensation of pressure drawing inward from epigastric region to back.

Past History
Recurrent cough & coryza, chickenpox, typhoid, and ulcers on sacrum.

Family History
Respiratory difficulty (Uncle).

Personal History
Tobacco chewing, smoking.

Investigations
1. X-ray: (13/07): Clear lungs. Obscured Right costophrenic angle, most likely by pleural effusion. Cardiomegaly.
2. ECG: (28/06): Tachycardia with irregularity.
3. USG: (21/07): Normal other than a small cyst in Rt. Kidney but it was noticed that patient has bilateral pleural effusion as well as pericardial effusion.
4. Blood test: Hb%= 12.2gm; TLC= 4,600; DLC= N:74%, L: 23%, M:0%, E :3%, B:0%; ESR= 02 mm; Serum urea: 28.9 mg/dl; Serum creatinine : 1.0 mg/dl.
5. Urine R/M = Normal.


Repertory Sheet


Discussion on Homoeopathic Management:
   This is a case of CCF, which in itself indicates a condition with advance pathology and acute emergency. This was treated with application of all homoeopathic principle, with the use of both low and high potency successfully. After Repertorisation and discussion with Materia Medica it was clear that the case required Pulsatilla and prescribed but on third day severe aggravation observed. Hence, Digitalis 3X was prescribed to stabilise the acute condition. With Digitalis 3X after two days severe palpitation was controlled but oedema increased on dependent parts, and massive hydrocoele developed with decrease in urine output. Therefore, Apis Mel 30 prescribed and followed by Apis Mel 200 on next day. Patient got relief of dyspnoea but no changes in progressive oedema with no change in urine output observed.

   Cardiologist advised for urgent need of diuretics and shift to allopathic hospital but the patient wanted to continue with homoeopathic management and was not willing to go because of previous intolerance with allopathic treatment, then Strophanthus Q was prescribed. On next day, it was observed that urine output improved and came to normal in 8 days. On 28/07/10 patient again complained of decreased in urine output and increased pedal oedema with constipation and < in warm room and > open air. On these, Symptoms Pulsatilla 200 prescribed and patient again started improving, and patient became symptom free on 04/08/10. Now our aim was to withdraw the Mother tincture as its action has been achieved. Hence, Strophanthus Q was stopped and Pulsatilla 0/2 OD was started. Patient was kept under observation for 7 days, no recurrence of symptom found with stable general condition (Refer the plate before and after treatment).

   So on 09/08/10 patient was discharged from hospital IPD and asked to continue follow-up in OPD.

Comparison of follow-up investigations:

Improvement in condition was concluded by comparison of previous and recent investigations:
Chest X-ray (13/07/10): Obscured right costophrenic angle, most likely by pleural effusion. Cardiomegaly.
Chest X-ray (22/08/10): Clear and hyperinflated lungs, well defined diaphragm and costophrenic angles. Cardiomegaly shown. [There is no longer any evidence of pleural effusion]
ECG on (28/06/10): Reported tachycardia with irregularity.
ECG done later (27/08/10): Still showed some variations in intervals between beats but the heart rate now was about 100 per minute instead of the original 120 per minute.

Conclusion:
   This discussion is an attempt to describe the homoeopathic approach planned to relieve the patient of Congestive Cardiac Failure with homoeopathic medicines. When keen observation of the conditions or symptoms is done periodically, along with use of indicated remedy in appropriate potencies (low and high) then its desired effect of providing relief to the patient can be achieved. In this case it has been demonstrated how action of homoeopathic medicines have helped to successfully stabilise the action of the heart in a patient suffering from a disease as severe as Congestive Cardiac Failure.