Full Recovery From Severe Dilated Cardiomyopathy

A man of 44 years was admitted to the hospital for severe dysnea. He had jugular venous distention, a third heart soung, and a laterally displaced point of maximal impulse, clear lungs, and 1+ edema in his feet. An ECG showed normal sinus rhythm. He had been schedule for an echocardiogram, when his severe dyspnea developed and he went to the emergency department.
The patient was given increasing doses of intravenous furosemide, but he became oliguric, and Cheyne-Stokes respiration developed. All of a sudden, the patient’s blood pressure diminished, and he was intubated emergently for hypoxia. Therapy with dopamine, dobutamine, nitroprusside, etc was started.
During the next 4 days, his cardiac output and urinary output slowly improved, and he was extubated. Dopamine, dobutamine, and nitroprusside were tapered, with continued administration of intravenous diuretics. On day 8 of hospitalization, with normalization of his renal function, a captopril regimen was begun, and on day 12 he also began receiving carvedilol, warfarin, and digoxin. On day 14, he was able to ambulate on room air without dyspnea, and he was discharged.
During the following 4 months, he noted steady improvement in his exercise endurance, and he was compliant with all his cardiac medications. Five months after hospitalization, an echocardiogram showed marked reduction in left ventricular size and moderate improvement in left ventricular function. The patient continued to improve steadily. 10 months after hospitalization, an echocardiogram showed full normalization of all heart chamber dimensions and a left ventricular ejection fraction of 50%.
One year after hospitalization, the patient was seen in follow-up and reported that he was feeling well and had stopped all his remaining medications 3 weeks before. His physical examination was normal. Six months after stopping all medications, another echocardiogram showed normal cardiac chamber sizes and normal cardiac function.

I found this article particularly interesting because this is exactly what we are learning in class at the moment. The applications of histamine and others, echocardiograms, etc—we have discussed these topics in class, and it’s fascinating to me how we as students have enough knowledge now to read a doctor’s report and understand perfectly what he or she meant, even the given concentration of certain ions, as in the original journal. I was happy to comprehend this journal, and excited to be learning about such an interesting topic. Moreover, it is amazing how medicine has advanced, that with acquired knowledge of how the body works (physiology), one can prescribe medicines and save somebody’s life.

http://www.medscape.com/viewarticle/410399_2