Dilated myopathy after giving birth
Geplaatst: za sep 10, 2005 4:15 pm
Hello everyone
I am Praveen from South Africa
I write here for my wife.
Below is 2 reports from the doctor that describe her condition.She got the myopathy after giving birth to our baby girl in 1998.THe reports below are outdated in date at but our last visit to the Cardiologist last year, he said that her condition was almost still the same, although he sees that her
heart size is becoming normal again.Currently she gets short breath during mild exertion.The medication she is on also causes her put on alot of weight.She is unable to exercise, she gets short breaths.When she tries Yoga exercises, her stomach blows up.
REPORT ONE
Thank you for referring Mrs Naidoo on the 9 September 1998.
Approx. 2 weeks ago she presented to you with a bronchitic illness and a wheeze. She was treated with Bisolvon and Zinnat and did not respond well. A subsequent chest x-ray showed cardiomegaly with features of heart failure. She was then assessed by Dr P L Perumal and the diagnosis was the she most likely had a postpartum cardiomyopathy. She was treated with Lasix, Slow K and Capoten and discontinued all of this treatment because of severe headaches. She now presented to you again with cardiac failure which responded to a single dose of intravenous Lasix. There is no history of hypertension. She had gestational diabetes but her glucose levels are now normal. She delivered 2 months ago. There was no other relevant history.
General examination was normal except for obesity . There were no signs of cardiac failure except for a gallop rhythm. The pulse rate was 110/min and regular, BP 110/70. No murmurs were audible. The rest of the examination was normal.
The resting ECG showed sinus rhythm but no other abnormalities.
Echocardiography showed that all chambers were dilated with poor left ventricular function. There was global hypokinesis. Trivial mitral and tricuspid regurgitation was detected and there was evidence of pulmonary hypertension. All of the valves appeared normal on 2 dimensional echocardiography.
In conclusion, Mrs Naidoo has a cardiomyopathy which is most probably postpartum. I have explained to her the nature of her disease and that she needs to be on maintenance therapy. She has been maintained on Renitec 2.5mg bd, Slow K 1 bd and Lasix 40mg daily. She has also been advised to stay away from work and I will review her again in 2 weeks time.
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REPORT TWO
Herewith a report on Mrs Naidoo who was reassessed on the 17 March 2000.
Mrs Naidoo has heart failure due to cardiomyopathy, which is most likely idiopathic dilated cardiomyopathy. I first saw her on the 9 September 1998. She then presented with a 2 weeks history of wheezing and dyspnoea. She was found to be in heart failure and echocardiography showed dilatation of all chambers and poor left ventricular function. She was initially treated with Renitec, Lasix and Slow K. On the 31 October 1998 she was admitted to hospital in severe heart failur. She gradually responded to intravenous Lasix. Since her discharge from hospital she has been seen very frequently for follow up and for episodes of severe dyspnoea. Her treatment has been altered over the years depending on her reponse. Her current medications are Dilatrend 3.125mg bd, Renitec 5mg bd, Lasix 80mg daily, Swiss Kal 2 daily and Zaroxolyn 2.5mg whenever necessary.
When seen on the 17 March 2000 she complained of increasing shortnes of breath for 2 weeks. She was also getting orthopnoea and nocturnal dyspnoea and needed to take Zaroxolyn on a daily basis. She was in NYHA functional class III.
ON examination there were no objective signs of heart failure. BP 115/80, pulse rate 62/min.and regular.
Echocardiography shows a dilated left ventricle with reduced systolic function. The EDD is 62mm and ESD 48mm. EF 44%. All of the valves appear normal.
I have added Aldactone 25mg daily to her treatment.
In conclusions, Mrs Rita Naidoo has heart failure due to idiopathic dilated cardiomyopathy. At present she is NYHA functional class III. She gets shortness of breath on mild to moderate exertion and is unable to even take care of her child properly. Her longterm prognosis is poor and she may ultimately require heart transplantation.
Current Medication as of September 2005
Flurosomide : 1 a Day 40 mg ( This is the Generic of Lasix)
Carloc – 3.25 2 times a day ( This is the generic of Dilatrend)
Spiractin 1 a day
Pharmapress 20 mg 1 a day ( This was substituted for Atacand)
Any help will be appreciated
I am Praveen from South Africa
I write here for my wife.
Below is 2 reports from the doctor that describe her condition.She got the myopathy after giving birth to our baby girl in 1998.THe reports below are outdated in date at but our last visit to the Cardiologist last year, he said that her condition was almost still the same, although he sees that her
heart size is becoming normal again.Currently she gets short breath during mild exertion.The medication she is on also causes her put on alot of weight.She is unable to exercise, she gets short breaths.When she tries Yoga exercises, her stomach blows up.
REPORT ONE
Thank you for referring Mrs Naidoo on the 9 September 1998.
Approx. 2 weeks ago she presented to you with a bronchitic illness and a wheeze. She was treated with Bisolvon and Zinnat and did not respond well. A subsequent chest x-ray showed cardiomegaly with features of heart failure. She was then assessed by Dr P L Perumal and the diagnosis was the she most likely had a postpartum cardiomyopathy. She was treated with Lasix, Slow K and Capoten and discontinued all of this treatment because of severe headaches. She now presented to you again with cardiac failure which responded to a single dose of intravenous Lasix. There is no history of hypertension. She had gestational diabetes but her glucose levels are now normal. She delivered 2 months ago. There was no other relevant history.
General examination was normal except for obesity . There were no signs of cardiac failure except for a gallop rhythm. The pulse rate was 110/min and regular, BP 110/70. No murmurs were audible. The rest of the examination was normal.
The resting ECG showed sinus rhythm but no other abnormalities.
Echocardiography showed that all chambers were dilated with poor left ventricular function. There was global hypokinesis. Trivial mitral and tricuspid regurgitation was detected and there was evidence of pulmonary hypertension. All of the valves appeared normal on 2 dimensional echocardiography.
In conclusion, Mrs Naidoo has a cardiomyopathy which is most probably postpartum. I have explained to her the nature of her disease and that she needs to be on maintenance therapy. She has been maintained on Renitec 2.5mg bd, Slow K 1 bd and Lasix 40mg daily. She has also been advised to stay away from work and I will review her again in 2 weeks time.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
REPORT TWO
Herewith a report on Mrs Naidoo who was reassessed on the 17 March 2000.
Mrs Naidoo has heart failure due to cardiomyopathy, which is most likely idiopathic dilated cardiomyopathy. I first saw her on the 9 September 1998. She then presented with a 2 weeks history of wheezing and dyspnoea. She was found to be in heart failure and echocardiography showed dilatation of all chambers and poor left ventricular function. She was initially treated with Renitec, Lasix and Slow K. On the 31 October 1998 she was admitted to hospital in severe heart failur. She gradually responded to intravenous Lasix. Since her discharge from hospital she has been seen very frequently for follow up and for episodes of severe dyspnoea. Her treatment has been altered over the years depending on her reponse. Her current medications are Dilatrend 3.125mg bd, Renitec 5mg bd, Lasix 80mg daily, Swiss Kal 2 daily and Zaroxolyn 2.5mg whenever necessary.
When seen on the 17 March 2000 she complained of increasing shortnes of breath for 2 weeks. She was also getting orthopnoea and nocturnal dyspnoea and needed to take Zaroxolyn on a daily basis. She was in NYHA functional class III.
ON examination there were no objective signs of heart failure. BP 115/80, pulse rate 62/min.and regular.
Echocardiography shows a dilated left ventricle with reduced systolic function. The EDD is 62mm and ESD 48mm. EF 44%. All of the valves appear normal.
I have added Aldactone 25mg daily to her treatment.
In conclusions, Mrs Rita Naidoo has heart failure due to idiopathic dilated cardiomyopathy. At present she is NYHA functional class III. She gets shortness of breath on mild to moderate exertion and is unable to even take care of her child properly. Her longterm prognosis is poor and she may ultimately require heart transplantation.
Current Medication as of September 2005
Flurosomide : 1 a Day 40 mg ( This is the Generic of Lasix)
Carloc – 3.25 2 times a day ( This is the generic of Dilatrend)
Spiractin 1 a day
Pharmapress 20 mg 1 a day ( This was substituted for Atacand)
Any help will be appreciated