Complains Of Breathless And Dizziness. Diagnosed With Irregular & High Rate Heart Beats & High Sugar Levels. Suggestions?

Posted on Fri, 13 Sep 2013

Question: My father Mr. XXXXXXX XXXXXXX aged 57 complained of breathlessness and dizziness last week. On further consultation with our family doctor, he was diagnosed with irregular & high rate heart beats & high sugar levels (plus 300 for both fasting & post meal). He is a diabetic since many years now & has in the past had high levels of sugar detected (plus 200) but never with a heart condition.

All his tests - cholesterol, lipid profile, etc has shown normal results. However, one of his tests - 'X-Ray Chet P.A view' performed yesterday gave the following result -
1. Prominent brochovascular marking are noted
2. Haziness of the bilateral tower zones are seen, which may be related to effusion versus overlying soft tissue
3. Mild cardiomegaly
4. Bony cage and soft tissue normal

I request his case be reviewed by your expert panel as soon as possible. His other reports have been attached afresh. Pls explain the condition as the doctor has currently given him a 15 day medicine course without mentioning if his condition is in fact that of mild blockage or anything else.

Answered by Dr. Ram Choudhary (1 hour later)

Brief Answer:
he seems to be in congestive cardiac failure

Detailed Answer:
Hi,
Welcome to healthcare Magic!
I have seen the reports of your father. The Xray , ECHO and TMT reports all are indicative of low reserve of the heart.
The dizziness and breathlessness may be due to fast irregular heart rate which is most commonly caused due to atrial fibrillation in most of such patients.
He has a history of poor control of the blood sugar such high levels of glucose cause slow damage in all systems of the body.
Your father should be admitted in hospital and should get the conteol of the fast heart rate to start with.
If there is no thrombus in cardiac Chambers then he should receive tje treatment to restore the normal sinus rhythm, which in fact can resolve much of the symtoms.
The haziness in xray seems to be related to pulmonary edema that has developed due to congestive heart failure due to irregular fast heart rate.
Occasionally such xray findings may be due to primary care of a physician.
I hope the advise would be informative and useful for you.
Take Care!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ram Choudhary (23 minutes later)

Thanks for your prompt response. Your response basis the reports suggests he should be admitted to a hospital asap, however his treatment doctor has told it is not required though he needs rest still. This is giving me a worry thus. Can you pls explain what a 'congestive cardiac failure' means in layman terms. Thx.

Answered by Dr. Ram Choudhary (11 hours later)

Brief Answer:
Atrial fib. and CHF should be urgently treated

Detailed Answer:
Hi XXXXXXX
Welcome to healthcare magic.
Cardiac arrhythmias leading to respiratory embarrassment may turn grave some times and patient may not give enough time to shift to health care facility.
If you have hospital nearby then maybe it can be practical for you.
The congestive heart failure is in fact a pooling of blood in heart which is not able to pump it out sufficiently.
As a result there is fluid logging of the lungs due to increased back pressure from the heart blood column, fluid exudes in lung spaces which are meant for oxygen to enter in body and so respiratory embarrassment of cardiac cause starts.
Your physician would know the regimen after examining him to reduce this state of failure.
I hope the advice will be helpful for you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ram Choudhary (8 hours later)

Hi,

I have attached two more files showing the medication prescribed by his current doctor. Can you pls review if this suits fine with his condition and if anything is missing still. Thanks.

Answered by Dr. Ram Choudhary (8 minutes later)

Brief Answer:
most of the drugs are okay

Detailed Answer:
Hi
Welcome back to XXXXXXX
Most of the drugs are visible and correct.
Ask your physician to add a combination of ACEI or ARB plus Thiazide combination if he think it appropriate.
If these medicine can be given they may improve the outcome.
Keep a close watch on the sugar levels.
I hope the advise will help your father's management.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ram Choudhary (12 minutes later)

Hi Doctor,

Thanks for your prompt response !! I'll discuss with the treating doctor and come back to you XXXXXXX for further queries if any.

Regards,
XXXXX

Answered by Dr. Ram Choudhary (25 hours later)

Brief Answer:
You are welcome

Detailed Answer:
Hi XXXXXXX
Welcome back to healthcare Magic!
i think your father will improve with treatment and he should take the medicines for life under physician supervision. i will be happy to advise for him.
I hope the advise would be informative and useful for you.
Take Care!

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar