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  • Alcohol Multisystemic Disease Case Presentation

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    Stella CooKey
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    1. A 50-year-old woman presented with leg swelling, breathing difficulties, and cough. She has a history of hypertension, diabetes, and heavy alcohol use of 60g per day for 20 years. 2. Examination found leg swelling, breathing issues, and signs of heart and lung problems. Tests showed diabetes, liver and kidney dysfunction from heavy drinking. 3. She was diagnosed with heart and lung disease caused by long-term heavy drinking and diabetes. Her condition continued to worsen with further complications found at each follow-up, demonstrating the effects of alcoholic multisystem disease on her body.

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    1. A 50-year-old woman presented with leg swelling, breathing difficulties, and cough. She has a history of hypertension, diabetes, and heavy alcohol use of 60g per day for 20 years. 2. Examination found leg swelling, breathing issues, and signs of heart and lung problems. Tests showed diabetes, liver and kidney dysfunction from heavy drinking. 3. She was diagnosed with heart and lung disease caused by long-term heavy drinking and diabetes. Her condition continued to worsen with further complications found at each follow-up, demonstrating the effects of alcoholic multisystem disease on her body.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    10 views14 pages

    Alcohol Multisystemic Disease Case Presentation

    Uploaded by

    Stella CooKey
    1. A 50-year-old woman presented with leg swelling, breathing difficulties, and cough. She has a history of hypertension, diabetes, and heavy alcohol use of 60g per day for 20 years. 2. Examination found leg swelling, breathing issues, and signs of heart and lung problems. Tests showed diabetes, liver and kidney dysfunction from heavy drinking. 3. She was diagnosed with heart and lung disease caused by long-term heavy drinking and diabetes. Her condition continued to worsen with further complications found at each follow-up, demonstrating the effects of alcoholic multisystem disease on her body.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 14

    A CASE OF ALCOHOL

    MULTISYSTEMIC DISEASE
    BIODATA
    NAME-Miss O.L
    AGE-50 years
    OCCUPATION-business woman
    ADDRESS-NO 307 aba road portharcourt
    RELIGION-Christian
    PRESENTING COMPLAINTS
    Presented to the accident and emergency with complaints of;
    •Bilateral leg swelling
    •Breathlessness x 1/12
    •Cough
    •Known hypertensive and diabetic diagnosed 3 years ago in chemist shop with poor drug
    adherence.
    EXAMINATION FINDINGS
    O/E- Middle aged woman in mild respiratory distress, afebrile, not pale, acyanosed, not
    dehydrated ,bilateral pitting pedal edema
    Spo2-90%, RBS-22.6mmol/l, HB-12.2%, RVS-Negative, urinalysis; Glucose-2+
    PR-101b/m
    BP-162/119mmHg
    HS-S1,S2,S3

    RR-24c/m
    Bibasal crepitations
    IMP-Hypertensive heart disease
    Hyperglycemia
    PLAN
    Chest x-ray, ECG, serum E/U/CR
    •IV furosemide 60mg stat then tab torsemide 20mg b.d x 5/7
    •Tab amlodipine 10mg daily x5/7
    •Tab Glucophage 500mg b.d x5/7
    •Refer to MOPC
    1ST MOPC CARDIOLOGY APPOINTMENT
    Still complains of bilateral leg swelling, dyspnea on exertion, cough productive of mucoid sputum
    and generalized body weakness.
    No palpitations, no chest pain.
    Has never been admitted or had similar illness in the past.
    Significant alcohol ingestion in the past. Takes an average of 60g/day for 20 years.

    O/E-Chronically ill looking, afebrile(36.3), not pale, anicteric, acyanosed, not dehydrated bilateral
    pitting pedal edema up to the knee. FBS-2.5mmol/l . Repeated RBS- 6.0mmol/l
    CVS-PR-97 b/m small volume regular, RRS, no TAW, no LCB
    BP-123/93mmhg
    JVP-8cm H2O [increased]
    Hyperactive precordium
    Apex beat- 6LICS AAL
    HS-S1,S2,S3+Apical PSM
    Chest-Bibasal crepitations + coarse crepitations in right middle lung zone
    ABD-Hepatomegaly
    ASS-CCF 2ry to HHDX ppt by LRTI
    PLAN-
    Do HBA1C,chest x-ray, se/u/cr, FLP, FBG
    •Continue antibiotics. (patient was already on them)
    •Tab digoxin 0.125mg daily x2/52
    •Tab torsemide 20mg b.d x2/52
    •Tab losartan 50mg daily x2/52
    •Tab clopidogrel 75mg daily x 2/52
    •Tab rosuvastatin 10mg nocte x2/52
    •See in mopc in 2/52
    2ND MOPC CARDIOLOGY APPOINTMENT
    Result of se/u/cr –
    Na-135mmol/l
    K-3.0mm0l/l
    HCO3-27mmol/l
    Urea-4.6mmol/l
    CL -89mmol/l
    Cr -84umol/l

    FBG- 8.7mmol/l
    HBA1C-9.7%
    FLP-
    Triglycerides-1.09mmol/l
    Total cholesterol-4.4mmol/l
    HDL cholesterol-1.01mmol/l
    LDL cholesterol-2.95mmol/l
    Chest x-ray report-unfolding of the aorta with cardiomegaly of LV strain; apex of the heart at the
    left lateral chest wall
    IMP- HHDx
    Nil fresh complaints
    O/E-Middle aged woman in no obvious distress, afebrile, not pale anicteric, acyanosed, not
    dehydrated, mild bilateral pitting pedal edema.
    CVS-PR- 78b/m small volume regular
    BP-131/104mmHg
    HS-S1,S2,S3+Pansystolic murmur loudest at the apex region
    RESP- RR-24c/m
    chest is clear
    ASS- Hypokalemia
    HHDx
    Type 11 DM
    PLAN-
    •Do ECHO,ECG
    •Tab Glucophage 500mg b.d x2/52
    •Tab slow k 600mg b.d x1/52
    •Tab rosuvastatin 10mg daily x2/52
    •Tab torsemide 20mg b.d x 2/52
    •Tab digoxin 0.125mg daily x2/52
    •Tab losartan 50mg daily x2/52
    •Tab clopidogrel 75mg dailyx2/52
    •Refer to endocrine clinic
    •To see in cardiology clinic in 2/52
    3RD MOPC CARDIOLOGY APPOINTMENT
    C/O-drowsiness, black spots on the palms and soles of the feet
    RBG-15.4mmol/l
    Clinically –palmar and plantar melanosis in addition to previous findings
    Temp -37.0, PR-96b/m, BP- 139/108mmHg, weight-62kg, height- 155cm
    Assessment-Alcoholic multisystemic disease
    PLAN-
    •Do LFT, Echocardiography
    •Tab Glucophage 1g dailyx4/52
    •Tab rosuvastatin 10mg nocte x4/52
    PLAN cont’d
    •Tab digoxin 0.125mg daily x4/52
    •Tab carvedilol 6.25mg daily x4/52
    •Tab coversyl plus 5/1.25mg daily x4/52
    •Tab clopidogrel 75mg daily x4/52
    •Tab furosemide 40mg dailyx4/52

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