dilated cardiomyopathy

[vikramdawar29]

Sir,my sister  aged 29yrs was diagnosed with dialted cardiomyopathy after giving delivery her second daughter in jan'06 by casearian operation.Her first daughter was born in nov'03. with an ef of 25% in oct'06.She got treatment from escorts specialty centre,where after the tests she was recomended the following medicines:digoxin,cardiovas,dietor20.However,inspite of taking all precautions,when another echo was done in may'07,her ef had fallen to 15%.A colour dopler test was also done,the result of which was normal.The doctor at escorts specialty centre in a very rude reply said that now there was only 2 treatments-stem cell or heart transplant
We consulted doctors at Ganga Ram hospital at New Delhi,where we were advised that stem cell therapy was still in experimental stage and that heart transplant was not possible.They also ruled out the pacemaker.However,they prescribed the same medicines as above.Another echo done in Ganga Ram hospital showed that her heart size had reduced by 5mm.This was an encouraging sign as advised by doctors.On 21stAug'07,my sister talked to us late in night and said that she was normal and feeling ok.however,to our shock in the morning of 22nd Aug'07,we received a call from the in laws of my sister that she has expired and that they rushed her to the hospital where the doctors declared her brought dead.In her post mortem report it was also found that her stomach was empty though she told in the night that she had dinner.The report further said that he died of heart attack.
I till this date can't figure out that how she all of a sudden had an heart attack nad that also so severe that she expired,and her daughters and husband who were sleeping next to her could not get to know.How come?It is also to mention that my sister had a lot of mental tension due to constant nagging by the in laws.
kindly explain.the doctors and friends.Plz,i shall be grateful.

[Dr J Singh]

Hello,

Stem cell therapy is still in the nascent stage.It will take some time for it to become a definitive therapy.Hence it’s possibility is virtually ruled out.I don’t think a pacemaker would have helped in your sister’s case because pacemakers are recommended only if the patient is suffering from bradyarrthythmias or marked slowing of the heart rate which I hope was not the case with your sister. A hyperactive thyroid can lead to worsening of cardiomyopathy and thyroid functions should have been evaluated. In sudden cardiac deaths, everything progresses so fast that the patient doesn’t get time to wake up even the sleeping beside him/her. I can understand that your sister was suffering from some mental stress which can cause the worsening of cardiomyopathy but cannot become a cause of cardiomyopathy.Truly speaking, the only definitive therapy for your sister was heart transplantation.

Hope it helps.Take care and pls do keep me posted on how you are doing.

[grendslori]

I am so sorry for your loss. At times like these, families need to know what happened so that they can find closure. It is certainly possible for your sister to die suddenly even sleeping next to her husband without anyone, including her, to be aware of what is happening. Stem cell research is still in the very early stages of development, even in this country. I think Houston is the only place here in the USA that is doing this kind of research. Some patients are told that they are not candidates  for transplantation because they are 'too sick' and that sounds like that was the case with your sister. Had they done the surgery on her, she would have died on the table. Patients who have a cardiomyopathy should not carry children due to the added stress on the heart during pregnancy. Thyroid testing would not have to be done for this disease. Family members should also be tested to make sure that this is not a genetic problem in your family. Your sister may have had a lot of stress due to her in-laws, but that was not the cause of her death, her cardiomyopathy was the cause. Again, I'm sorry for your loss.

SLK

[vikramdawar29]

Respected sir,
                    thanks for your reply.However,my query on stem cell therapy remains unanswered.Further,would a pacemaker had helped.Since there were no immediate reasons for my sister to get this problem,would the cardiologist of Escorts Specialty centre looked into aspects such as thyroid also,in finding the cause of this disease.Why the medicines did not take the desired effect on my sister and inspite of taking these medicines,the condition did not improve.Most important to mention,she was under great mental tension from her in-laws,sister-in-law side.would my sister did not get time to wake anybody slleeping alongside her,when she started feeling discomfort.
                  Please reply.I shall be grateful
                  

[Dr J Singh]

Hi,

Well, sudden cardiac death is known to occur in patients of dilated cardiomyopathy, which usually occurs due to any abnormal rhythm of the heart which is common in these patients. Heart attacks are also common in this population as the blood is not flowing freely in the chambers of the hart as in a normal person and hence there are chances of formation of clots which can travel to the coronary arteries(arteries which supply blood to the heart) and thus lead to heart attack.

Regarding the absence of food in the stomach on autopsy. Well, the food leaves the stomach within 2 hrs of consumption and thus stomach becomes empty quite fast.

I don’t think you need to doubt/have suspicion on her in-laws based on these facts.

I hope that helps. Pl do keep me posted. Kind Regards.