Heart Failure Patient Experiences Significant Relief Through Medication Therapy
Heart failure is a common clinical condition characterized by symptoms such as shortness of breath and difficulty breathing. In this case report, we follow the journey of a 72-year-old male patient suffering from left ventricular failure. Upon admission to the hospital, he experienced worsening dyspnea without any obvious trigger, making it impossible for him to lie flat. After receiving a comprehensive treatment plan involving diuretics, cardiac support, vasodilators, and anticoagulants, his symptoms improved significantly within a week, and his condition stabilized.
Case Overview
Patient: Male, 72 years oldCondition: Left Ventricular FailureHospital: First Affiliated Hospital of Xi'an Jiaotong UniversityVisit Date: May 2022Treatment: Intravenous therapy (Papaverine Hydrochloride Injection, Sodium Nitroprusside for Injection) + oral medications (Furosemide Tablets, Metoprolol Succinate Extended-Release Tablets, Digoxin Tablets, Rivaroxaban Tablets, Warfarin Sodium Tablets)Therapy Duration: One-week hospitalization, followed by one-month follow-up and long-term medicationOutcome: Complete resolution of dyspnea, stable condition
Initial Presentation
The patient experienced sudden dyspnea three hours prior to admission while getting up to urinate. He remained conscious but exhibited rapid breathing, profuse sweating, and was unable to lie flat. There were no signs of chest pain, fever, or cough with sputum production. Initially, he self-administered quick-acting heart-saving pills, which provided slight relief, but symptoms soon worsened again. Upon arrival at the emergency department, a chest CT was performed, and intravenous Papaverine Hydrochloride was administered. Blood tests revealed a B-type natriuretic peptide precursor level of 2429.0 pg/L, confirming the diagnosis of left ventricular failure. The patient was subsequently admitted for further management.
Treatment Plan and Progress
Upon admission, the patient received oxygen therapy and continuous electrocardiographic monitoring. A comprehensive treatment strategy was discussed with the patient and family, including diuretic therapy with oral Furosemide to increase urine output, intravenous vasodilation using Sodium Nitroprusside to reduce cardiac workload, and beta-blockade with Metoprolol Succinate to mitigate sympathetic nervous system effects. Cardiac contractility was enhanced using Digoxin Tablets. Additionally, anticoagulation therapy with Rivaroxaban and Warfarin Sodium was initiated to prevent thrombosis. After one week of treatment, the patient's symptoms improved significantly, allowing for discharge planning.
Clinical Response and Recovery
Prior to treatment, the patient was unable to lie flat and experienced severe dyspnea. After one week of medical therapy, he reported substantial improvement in breathing difficulties, with no worsening symptoms during routine physical activity. A follow-up B-type natriuretic peptide precursor test showed a level of 404.0 pg/L, indicating a return to normal range. The patient was advised to continue his prescribed medications at home and schedule a follow-up visit in one month. Any recurrence of symptoms would warrant immediate medical attention.
Post-Discharge Recommendations
As the patient's condition stabilized, we emphasized the importance of lifestyle adjustments and continued care after discharge:
- Medication Adherence: Strict compliance with prescribed dosages is crucial. Family members should monitor medication schedules to prevent missed or extra doses.
- Dietary Management: A low-sodium, low-fat, and low-sugar diet is recommended to prevent fluid retention and reduce cardiac strain.
- Physical Activity: Light exercises such as walking or tai chi are encouraged, provided the patient feels well enough to engage.
- Smoking Cessation: The patient had a history of smoking, so quitting was strongly advised to improve long-term heart health.
Clinical Insights
Left ventricular failure typically results from weakened myocardial contraction, leading to impaired cardiac output and pulmonary congestion. This often manifests as dyspnea, including exertional breathlessness, orthopnea, and paroxysmal nocturnal dyspnea. In this case, the patient presented primarily with unexplained shortness of breath and inability to lie flat. With timely and appropriate pharmacological intervention, his symptoms resolved effectively. However, ongoing self-monitoring remains essential, and any recurrence of respiratory issues should prompt immediate medical evaluation.