Right Ventricular Failure Patient Experiences Relief After Proper Treatment
In this case study, we explore the successful treatment of a 65-year-old woman suffering from right ventricular failure. Her symptoms included chest tightness, shortness of breath, and leg swelling. With timely diagnosis and appropriate medical care, her condition significantly improved. This article is intended for informational and educational purposes only, and patient confidentiality has been maintained.
Case Overview
Patient: Female, 65 years oldDiagnosis: Right ventricular heart failureHospital: First Affiliated Hospital of Xi'an Jiaotong UniversityTreatment Period: June 2021Treatment Plan: Combination of oral medications (acarbose, metformin, irbesartan, furosemide, digoxin, nitroglycerin) and subcutaneous insulin injectionsHospital Stay: 7 days, with follow-up after one monthOutcome: Significant symptom relief, including resolution of chest discomfort, shortness of breath, and leg swelling
Initial Consultation and Diagnosis
The patient reported experiencing unexplained chest tightness, shortness of breath, and bilateral leg swelling four days prior to her visit. These symptoms were particularly noticeable during physical activity or at night, often accompanied by episodes of breathlessness that prevented her from lying flat to sleep. Self-medication had failed to provide relief, prompting her to seek professional care. She also reported poor appetite, trouble sleeping, and constipation.
Upon physical examination, her heart dullness was found to be enlarged, with a regular but weakened heartbeat. No heart murmurs or pericardial friction rubs were detected. Her pulse was 58 beats per minute and regular. She exhibited moderate pitting edema in both legs. An ECG showed sinus rhythm, complete left bundle branch block, and ST-T wave changes. Based on these findings, she was diagnosed with right ventricular failure and admitted for treatment.
Treatment Plan and Progress
Further lab tests confirmed elevated levels of NT-proBNP (>35,000 pg/mL), reinforcing the diagnosis of right heart failure. The treatment plan included furosemide to reduce fluid retention and alleviate swelling. Nitroglycerin was administered to dilate blood vessels and reduce cardiac workload. Digoxin was prescribed to strengthen heart contractions and relieve chest discomfort caused by weakened cardiac function.
Within three days, the patient's blood pressure and blood sugar levels normalized, and symptoms began to ease. By day five, her breathing difficulties had disappeared. On day seven, the leg swelling resolved completely. She was discharged in stable condition.
Follow-Up and Recovery
One month after discharge, the patient returned for a follow-up visit. Her vital signs remained stable, and there was no recurrence of chest tightness, shortness of breath, or leg swelling. She expressed satisfaction with the treatment results and was advised to continue monitoring her health closely.
Key Recommendations for Patients
While the patient responded well to treatment, ongoing care is essential in managing right ventricular failure. Here are some important lifestyle and health tips:
- Stay Warm: Avoid cold exposure, as it can worsen symptoms or trigger a relapse.
- Healthy Diet: Eat low-fat, bland meals and avoid heavy or spicy foods. Eat small, frequent meals to avoid overeating, which can strain the heart.
- Rest and Relaxation: Get adequate rest and avoid overexertion. Stress and anxiety can negatively impact heart function.
- Regular Monitoring: Follow up with your doctor as scheduled and seek immediate care if symptoms return or worsen.
Clinical Insights and Conclusion
Right ventricular failure is a serious condition that requires prompt and effective management. In this case, a combination of medication and lifestyle adjustments led to a positive outcome. It's also crucial for patients with underlying conditions like diabetes or hypertension to manage them properly, as these can significantly influence heart health.
Early recognition of symptoms such as shortness of breath, fatigue, and leg swelling is key to timely intervention. Delaying care or attempting self-treatment can lead to severe complications. If you or a loved one experiences these symptoms, it's essential to consult a healthcare provider as soon as possible.