Cardiomegaly{Hypertrophy Heart}

Means enlargement of any chamber/chambers of heart. If Right side of heart chambers is enlarged, Right Cardiomegaly. If left side of chambers enlarged, left Cardiomegaly. If only both upper chambers are enlarged, aortic hypertrophy. If only both lower chambers are enlarged, ventricular hypertrophy. Among all types of hypertrophies, LEFT VENTRICULAR HYPERTROPHY [LVH] is most common. Here in this article I deal with only CLINICAL ASPECTS of LVH, because LVH is common, among all types of hypertrophies of heart.

Clinical causes of LVH are:-

1. Hereditary
2. Diabetes Mellitus
3. Anxiety Neurosis
4. Hypertension Idiopathic
5. Chronic Renal Failure
6. Prolonged stresses & strains
7. Excessive Alcoholism
8. Narcotics
9. Sedentary Life
10. Tobacco Smoking/Chewing

Clinical Diagnosis of LVH by sign and symptoms:-
Following Symptoms clinically judge LVH:-

1. Palpitation. Palpitation may associate with anxiety, nausea, restlessness, suffocation. Some patients complain palpitation with anxiety. Some may complain palpitation with nausea. Some may complain palpitation with restlessness. Some may complain palpitation with suffocation feeling. Most prominent symptom of palpitation is that palpitation worse lying on left side, because of effect of gravity.

2. Dyspnoea. Patient complains difficult breathing on slightest exertion. Sometime difficult breathing associated with suffocation feeling even on rest.

3. Suffocation. Patient may complain of suffocation in warm room, closed room. Suffocation better open air.

4. Retrosternal Pain. Patient complains of Retrosternal pain which worse on lying on left side, because of gravitational force. Retrosternal pain may occur with or without palpitation.

5. Hypertension. High blood pressure is prominent manifestation of LVH. High blood pressure manifest with various symptoms according to individuality of patients. Few patients may complain of body ache during hypertension. Few patients may complain of pulsating pain sides of head or pulsating temporal. Few patients complain of heat vertex during high blood pressure.

6. FEVER, COUGH & CORYZA in heart patients causes serious emergency condition. Cough in LVH may be due to edema of lungs & around heart, which results prolonged and severe episodes of coughing.

7. EDEMA Generalized edematous swellings in LVH indicate severe condition of heart.

8. TACHYCARDIA Pulse rate above 100/minute indicate tachycardia.

Confirmation of LVH:-

1. E.C.G. Electrocardiography shows:-

{A} Increased QRS Complex voltage in leads L1 & L11

{B} Prolonged Time Interval 0.09 to 0.12 seconds in Leads L1, L11 & L111.

{C} QRS complex inverted and Prolonged in Lead L111.

{D} QRS complex inverted (electronegative) in Lead aVF.

2. ECHO. Echocardiography shows increased dimensions of left ventricle along with decreased ejaculation fraction.

MANAGEMENT OF LVH:-

This section includes followings:-

1. Bed Rest to avoid unnecessary burden on heart pumping system. Complete bed rest must be advised.

2. Avoidance of maintaining causes such as smoking, alcohol drinking habits. Change of place for piece of mind. Music therapy if change of place not possible. Other means to avoid excess stress & strain such as reading, watching funny serials.

3. Edema must be treated by increasing urine output.

4. Fever, cough & coryza must be subsided as soon as possible.

5. Diet should be free of carbohydrates, fats, coffee, cold drinks, meat, gullet {Madda} and spices. Restrict salt intake. Minimum quantity of salt in vegetables. Raw salt intake such as in salads must be prohibited. Fluid intake must be according to thirst. Advised to drink half of thirst. If thirst for one glass of water, advised to drink half glass instead of one glass water/fluid. Excess water/fluid intake & salt increased the severity of LVH patients by increasing EDEMA.

6. Advised to take plenty of raw vegetables such as cabbage, onions, garlic, tomatoes, ginger. Honey is backbone of heart. Soya been strengthening the heart. Fruits should be replaced instead of chapattis.

CASE-1

Case of Smt VM, age 45yrs diagnosed LVH along with DIABETES MELLITUS presenting with following symptoms on dated 14-02-2006:-

1. Fever with chilliness. Temp. 103.4*f.

2. Dyspnoea with palpitation. Palpitation with anxiety.

3. Retrosternal pain < lying on left side along with suffocation feeling. Suffocation < on exposure of smoke while cocking.

4. Sleep disturbed due to palpitation, lying on left side impossible due to Retrosternal pain along with palpitation.

5. Cough episodic severe attacks of cough.

Findings:-

6. Hypertension BP=160/90mmhg with pulsating headache left sided.

7. Tachycardia Pulse 130/minute.

8. Blood Glucose fasting above 300mg/dl

9. X-Ray on dated 14-02-2006 indicates Cardiomegaly with edema of lungs.

10. ECHO shows left ventricular hypertrophy with decreased ejaculation fraction along with systolic & diastolic dysfunctions.

Among Generals:-

Sleep disturbed due to Retrosternal pain, palpitation and cough along with fever, body ache.

Appetite reduced due to fever.

Thirst increased.

Stool hard constipated. Sometime hemorrhoid painful, bleeding.

Urine normal.

Desire & Aversion not specific.

Chilly Patient. Shaking with chill sometime without fever.

Among Mentals:-

Domination

Humiliation

Industrious

Impatience

Fastidious

Constitution Melancholic

Miasm Psoric & Sycotic.

Repertorization:-



From above Repertorization Remedy indicating is Calc-Carb acute of Calc-Carb Belladonna. Prescription made according to organon of medicine whenever patient comes under acute severe condition with organic changes, prescribed acute remedy lowest dose with frequent repetition. Bell 30 one hourly first day.

On next day dated 15-02-2006

Temp. = 98*f, chill better.

B.P. = 130/80 mmhg.

Pulse = 130/minute.

Retrosternal pain as such.

Palpitation Along with anxiety less than previous day.

Exert ional dyspnoea.

Appetite less.

Bell 30*3hrly prescribed.

On dated 16-02-2006

Headache throbbing better.

Exert ional dyspnoea.

Appetite increased slightly.

Cough slight off & on.

Retrosternal pain off & on.

Palpitation & anxiety better.

Sleep better.

Fever better.

B.P. = 110/70mmhg.

Pulse = 98/minute

Bell 30* tds prescribed.

After Two months on dated 23-04-06, patient was feeling better regarding constipation, hemorrhoids, Retrosternal pain, dyspnoea, cough, fever, palpitation, anxiety, appetite, sleep, and headache.

B.P. = 110/70mmhg.

Pulse = 90/minute

Prescribed Calc-Carb 30*1dose, followed by Placebo tds, because her general health was good and she was feeling energetic.

Case is running with gradual increase of potency of Calc-Carb 200 to 1M. Now patient is over Calc-Carb 1M followed by placebo tds. Her

Blood glucose level gradually recovered from 390 mg/dl to 133 mg/dl random. Case is following Hearing s Law of cure. Joints pain appeared after normalization of LVH. Three months after treatment ECHO shows Normal heart. X-Ray show normal heart size. {Reports of X-Ray, ECHO are with me, which indicate success of Dr. Hahnemann s Homoeopathy in Heart diseases.}

CASE-2

Smt. SRB, 45 yrs aged, presented on dated 21-12-2007 having Diabetes Mellitus, LVH along with I.L.D., Anxiety Neurosis, Cervical Spondylosis, Hepatomegaly along with fatty infiltration with following Symptoms:-

1. Cough since three months. Coughsitting>after expectoration.

2. Palpitation since 1994-95. Palpitation with dyspnoea and Suffocation feeling. Exertional dyspnoea.

3. Hypertension since 1994-95.

4. Anxiety Neurosis since after Parturition 30 yrs.

5. Cardiac Pain since 1994-95.

6. Insomnia since childhood.

7. Constipation since childhood. Unsatisfactory stool.

8. Pruritus Vulvae.

9. Anxiety stomach. > Juices, cold water drinking.

10. Fever since 3-4days. Temp. 99*f < exertion.

11. Itching. Urticaria
PAST HISTORY:-

H/O Hystectomy 1994-95.

H/O Recurrent injury from falling.

H/O Facial Paralysis Left sided 1995.

H/O Relapsing enteric fever.

Treatment History:-

Always Took Allopathic treatment.

Generals:-

Sleep:-

Sleepless after waking.

Dreams:-

Dead Relatives.

Crying with dreams of dead relatives.

Of Thoughts.

Appetite:-

Intolerance of hunger. Trembling from fasting.

Thirst:-

Poly dypsia.

Perspiration:-

Causes Itching in joints.

Urine:-

Polyurea. Sudden urging for urination, must escape, if delayed then involuntary.

Taste:-

Tasteless of food.

Desire:-

Juices, Sour Fruits.

Chilly patient.

Among Mentals:-

Delusion pursuing by someone while walking in dark.

Melancholic, Nervous constitution. Oversensitive to noise.

Repertorization:-




From above Repertorization remedy selected & prescribed Lycopodium. Potency 200 selected because of dominating Syphilitic miasmatic condition. Lyco 200*1 dose followed by placebo tds prescribed. Patient is running till this date and is free from cough which was not improving with strong antibiotics treatment. Initially increased in cough occur for first 24 hours, then gradual improvement. Cough was due to pericardial and lungs edema. Cough subsided as pericardial and lungs edema improved. Now till date she is free from coughing, palpitation, dyspnoea, anxiety stomach, tastelessness. Delusion gets better.

Constipation improving gradually. Joints pain increasing recovering from mesodermal organic level to connective tissue mesodermal level.

Sleep gradually recovering.

Findings:-

B.P. = 130/80 mmhg.

Pulse = 80/minute earlier 110/minute.

Blood glucose = 201mg/dl (R)

CASE-3

Smt. AS 38 yrs aged, consulted on dated 24-02-2008 with following symptoms:-

1. Headache with nausea. Nausea fasting.

2. Suffocation>open air.

3. Palpitation
4. Retrosternal pain< lying on left side.

5. Peripheral edema.

6. Hemorrhoids painful & bleeding profusely.

Findings:-

1. B.P.=150/100mmhg.

2. Pulse= 150/min. & missing.

3. Temp.= 99*f

4. X-Ray shows Cardiomegaly.

5. E.C.G. indicated QRS electronegative in Lead 111 & aVF.

Past-History:-

H/O Appendisectomy December 2005.

H/O Renal Calculi.

Among Generals:-

Sleep unrefreshing due to dreams.

Thermally sensitive to both heat and cold.

Mental:-

Patient is Nervous Lady.

Repertorization:-


From above Repertorization Remedy selected Lyco & Chelidonium which is acute of lyco. Lycopodium 200*1 dose prescribed followed by placebo tds.

Follow-ups after one weak

B.P. = 140/100mmhg.

Pulse = 130/minute & regular, earlier missing.

Palpitation persisting.

Headache better.

Suffocative attack persisting>open air.

Joint Pains start appearing.

Placebo tds continuous.

Follow-up after one weak (07-03-2008)

B.P. = 130/90mmhg.

Pulse = 110/minute & regular.

Suffocative attacks persisting.

Frequent urging for urination.

Pain joints.

Palpitation better.

Pain Retrosternal better.

Placebo tds continuous.

On dated 18-04-2008

Pain abdomen with nausea, diarrhea & vomiting occurred at night. After midnight patient came with severe dehydrated condition with severe pain in abdomen along with nausea, vomiting and diarrhea. Involuntary diarrhea. Nausea at sight of food. Restlessness with pain abdomen, lying here and there in order to obtain relief from severe abdominal pain. Dryness mouth with thirst small quantity often. Diarrhea watery involuntary and immediate after eating. Case again Repertorized on presenting symptoms:-


From above Repertorization remedy comes out Sulphur & its acute Aconitum nap. Sulphur 200 one dose prescribed followed by placebo tds. Next day morning pain abdomen was less. Nausea better. Diarrhea better. Vomiting better. Hemorrhoids pain appeared.

Follow-up 20-04-2008

Pain Abdomen slight after eating.

Nausea after tea, otherwise better.

Body ache.

Tasteless of food.

Hemorrhoids painful.

Palpitation better.

Retrosternal pain better.

Temp. = 100*f

B.P. = 130/90mmhg.

Pulse= 90/minute.

Beat regular.

Placebo tds continuous.

Follow-up 05-05-2008

B.P. = 130/90mmhg.

Pulse = 90/minute & regular.

Palpitation, dyspnoea, Retrosternal pain better.

Fever gets better with placebo. Here fever indicated positive response of immune system and body start reacting against invading harmful agents present inside body and disarranging vital force. Case following Hearing s law of cure as joints pain increasing with recovery of heart & hemorrhoids. Case is running with favorable prognosis.

These are few cases latest as well as old. Reports are with me before and after recovery. Many more cases records are there of LVH.

Comments & Suggestions invited respectfully.