A Case of Inferior & Right Ventricular Infarction
NATIONAL JOURNAL OF HOMOEOPATHY 2003 May / Jun VOL V NO 3.
Prof Dr Kasim Chimthanawala
'Camphor / Amyl-nit
The epidemics of cardiovascular disease, especially IHD are
emerging in developing countries and the incidence continues to rise. India is
no exception. It is estimated that up to three quarters of mortality in
developing countries results from various non-communicable diseases and coronary
artery disease tops the list of killers, surpassing even infectious diseases..
As a consequence, more and more patients of IHD with their attendant
complications are hospitalised and subjected to a battery of investigations.
Pathologically, it is generally accepted that Myocardial Ischemia, and its
extreme consequence - acute myocardial infarction, can result from a transient
or a permanent disproportion between myocardial oxygen demand and coronary
artery blood supply. Ischemic heart diseases can result from encroachment on the
coronary artery lumen by disease of the arterial wall (arteritis), intraluminal
obstruction (atheroma or embolism), or an excessive increase in myocardial
oxygen demand exceeding the ability of the normal coronary arterial system to
supply the needed blood (aortic stenosis). Of these, Atherosclerotic Coronary
Artery disorders form the major proportion of cases in our Out Patient
Department.
When we study the genesis of these disorders, it becomes obvious that the
disease spectrum has an evolutionary dimension. It starts from a functional
state and ends at an organic level (atherosclerotic plaque) with its attendant
secondary symptoms. Earlier it was accepted that the incidence of Myocardial
Infarction increases rapidly with age. But today there is an emergence of
Coronary artery disorders in the Young (> 40 yrs). The implications of
Ischemic Heart Disease in young patients go beyond prognosis, as repercussions
on the entire family structure and community commonly ensue with a growing
economic and social burden. It is apparent that there is a need to understand
better the potential to return to work, the degree of symptoms to be expected
vis a vis homoeopathic therapeutics in these patients..
This prompted the National Academy of Homoeopathy, India, to open a separate
Homoeopathic Cardiological Cell at its Central Secretariat at Nagpur, where
detailed homoeopathic study in this specific area can be undertaken.
Here under, I present one case of Subendocardial Inferior and right Ventricular
Infarction from our records.
Case:
Ma X, 22y, studying in B Sc, was brought at Shaad at around 2 am on 14/03/02
with:
1. Chest pain - sudden onset, Retrosternal, localized
dull aching.
2. Vomiting - twice, consisted of only food, non
projectile, No nausea
3. Prostration ++ with cold sweat +
4. Was anxious, restless & persistently wished to sit
in spite of having no breathlessness.
5. Disliked being covered (feet & hands were cold).
All complaints developed with increasing intensity within 1-2
hrs, while he was preparing for his exams. No such similar complaints reported
in the past. No H/O loose motions, palpitation, vertigo, abdominal pain or other
complaints except H/O active bleeding piles since 4 days.
O/E General condition not satisfactory; well built, restless
& cold.
Pulse-Reg 130/min, synchronous, low volume
BP 90/60 mm Hg, No Oedema feet, JVP - Not raised but HJR
positive.
No pallor/Icterus/clubbing; Central Cyanosis+. Face pale,
cold with profuse sweat all over,
CVS-HS 1st muffled, P2 loud, No S3
gallop
RS-RR 28/min thoraco-abdominal, Breath Sounds Vesicular.
No Rales.
PA - soft, Non-tender, Liver /Spleen- Not Palpable,
Kidneys-not ballotable, No E/o Ascitis, sounds+
PR - Grade 2 Haemorrhoids ++. CNS-NAD
