Individualized homoeopathy in valvular heart disease- A case report

KNOW Homoeopathy Journal Vol–3 & Issue-2, 18 October 2023, Published at https://www.knowhomoeopathyjournal.com/2023/10/volume-3-issue-2.html, Pages: 42-50 , Title: Individualized homoeopathy in valvular heart disease- A case report, Authored By: Dr. Neha Nagar (M.D.(Hom.), Assistant Professor in the Department of Repertory, Bakson Homoeopathic Medical College & Hospital, Greater Noida ) & Co-Authored By: Dr. Ravi Poswal (M.D.(Hom.), Associate Professor in the Department of Materia Medica, Bakson Homoeopathic Medical College & Hospital, Greater Noida), Dr. Ajay Kumar (M.D.(Hom.) - Assistant Professor in the Department of Pediatrics, Bakson Homoeopathic Medical College & Hospital, Greater Noida), Kanak Singhal (Intern, Bakson Homoeopathic Medical College & Hospital, Greater Noida)

CASE REPORT

Title: Individualized homoeopathy in valvular heart disease- A case report

Authored By: Dr. Neha Nagar ^[1] & Co-Authored By: Dr. Ravi Poswal^[2], Dr. Ajay Kumar^[3] , Kanak Singhal^[4]

^[1]M.D.(Hom.), Assistant Professor in the Department of Repertory, Bakson Homoeopathic Medical College & Hospital, Greater Noida

^[2]M.D.(Hom.), Associate Professor in the Department of Materia Medica, Bakson Homoeopathic Medical College & Hospital, Greater Noida

^[3]M.D.(Hom.) - Assistant Professor in the Department of Pediatrics, Bakson Homoeopathic Medical College & Hospital, Greater Noida

^[4]Intern,Bakson Homoeopathic Medical College & Hospital, Greater Noida

EDITORIAL BOARD PUBLISHER DETAILS COPYRIGHT POLICY DISCLAIMER

Received: 07/07/2023 Accepted: 18/09/2023 Published: 18/10/2023

How to cite this Case report:

Nagar N, Poswal Ravi, Kumar Ajay, Singhal K. Individualized homoeopathy in valvular heart disease- A case report, KNOW Homoeopathy Journal, 2023; 3(2):42-50, available at https://www.knowhomoeopathyjournal.com/2023/10/Individualized-homoeopathy-valvular-heart-disease-case-report.html

ABSTRACT

Introduction-Valvular heart disease includes a variety of common cardiovascular conditions that hold for 10% to 20%. Patients with valvular heart disease-related heart failure cannot supply enough blood that the human body requires. It is challenging to diagnose in all age groups, and it frequently co-exists with other heart conditions. Case summary- At the OPD (Outpatient Department) of Bakson Homoeopathic Medical College & Hospital, a 45-year-old female patient arrived with complaints of breathlessness and palpitation with an Echocardiogram in which Left ventricular ejection function was only 25-30 %. Firstly, she consulted modern treatment for this but there she was advised to go for surgery then she willingly wanted Homoeopathic treatment. After her detailed case taking and Repertorization Calcarea carbonica 200 c was prescribed. Result-After regular treatment for 3 months Echocardiogram showing Left ventricular ejection function is now 50%. Conclusion-This case report shows that we can use homoeopathic medicine as a preventive and first line of treatment for heart ailments also if a selection of medicine and potency will be based on homoeopathic principles.

Keywords: Echocardiogram, Homoeopathy, Repertorization, Valvular Heart Disease

Abbreviations: CVD (cardiovascular disease)

INTRODUCTION

Cardiovascular disease (CVD) is the leading global cause of death. 80 percent of CVD cases occur in developing nations.^{^[1]}, producing about 19% more fatalities than both war and malaria combined.^{^[2]} The decline in physical impairment and declining quality of life are both strongly impacted by valvular heart disease, one of the leading causes of cardiovascular illness and mortality in the world.^{^[3]}

TYPES OF VALVULAR HEART DISEASES

1-Valvular stenosis - Valvular Stenosis is a condition in which the heart valves stiffen, and blood flow is reduced as a result of the valve opening narrowing.

2-Valvular prolapse- The problem is called prolapse when the valve flaps (leaflets) slide out of place or bulge. This could cause the heart valve to shut unevenly or incorrectly.

3- Regurgitation (leaking)- When a valve does not close completely and blood flows backward, regurgitation can happen.

CAUSES

High blood pressure

Rheumatic Heart Disease

Endocarditis

Congenital Heart Valve disease

Atherosclerosis.

SYMPTOMS

Shortness of breath

Chest pain

Fever

Fatigue

Fainting

Dizziness

Irregular Heartbeat

TREATMENT

1-Surgery to repair the affected valve

2-Medicines to control your symptoms and keep your heart pumping well.^{^[4]}

DIFFERENTIAL DIAGNOSIS

Marfan’s syndrome
Atherosclerotic incompetence
Rheumatic aortic incompetence^{^[5]}

Homeopathy is a well-known holistic system of medicine. Medicine selection is based on symptom similarity. Very few case reports published that support the role of Homoeopathic medicines in such types of cases. In a case report namely ‘’The stenosed heart revived by homoeopathy’’- There was modest L.V. hypertrophy, an effective volume of 25–30%, dilated L.A, mitral stenosis, aortic regurgitation, and pulmonary hypertension before starting the medication. After 10 months of therapy, L. had no regurgitation or mitral stenosis, and the effective volume had improved from 25% to 36%. A normal mitral valve size, mitral leaflets that exhibit normal texture and excursion, and no pulmonary hypertension. This demonstrates that digitalis has a powerful effect on the heart, particularly the left ventricle and mitral valves.^{^[6]}

CASE SUMMARY

A 45-year-old lady presented with breathlessness on exertion for 2 years. Now difficulty in breathing has been getting worse from 5 days. Her complaints used to aggravate on the slightest exertion and she felt better in the open air and by rest. She was also complaining of pain in her chest ,pulsating type of pain, and stiffness in the cervical region on left side of her shoulder .

HISTORY OF PRESENTING COMPLAINTS

The patient was well after the death of her daughter in a roadside accident suddenly upon exertion, she first noticed dyspnea, which started slowly and progressed gradually. It was relieved with rest and by going in the open air only. At present, she can walk only 25–30 meters at a stretch. She also gave a history of palpitations. Similar palpitations had never before occurred. Hemoptysis, fever, or a chronic cough were not present in the past.

FAMILY HISTORY

Father died due to Tuberculous Meningitis.

PHYSICAL GENERALS

Appetite-Increased

Thirst-unquenchable

Desire-for milk

Stool-constipation, unsatisfactory stool

MENTAL GENERALS

Her problem got started after the death of her daughter. She always felt sad mainly in the morning. She wanted to live alone only. She felt restless at night with marked anxiety.

CARDIOVASCULAR EXAMINATION

The pulse was 92 bpm, irregular

In the right arm, the BP was 100/80 mm/hg.

There was no pedal edema.

Auscultation

An additional mid-diastolic murmur was present which was low‐pitched, rumbling non-radiating, best heard in lateral position with breath held in expiration, with presystolic extenuation Other systemic examination was unremarkable. There was no hepatomegaly or upper abdominal tenderness. The optic fundus was normal.

TOTALITY OF SYMPTOMS AFTER ANALYSIS AND EVALUATION

1-Breathlessness on exertion

2-Aggravation by the slightest exertion

3-Amelioration by open air and rest

4-Stiffness in the cervical region

5-Pulsating type of pain in the chest

6-Appetite-increased

7-Thirst-unquenchable

8-Desire for milk

9-Stool-constipation,unsatisfactory

10-Ailments after the death of her daughter

11-Felt sad mainly in the morning

12-Wanted to live alone

CONVERSION OF SYMPTOMS INTO RUBRICS

S.NO	SYMPTOMS	RUBRIC
1	Breathlessness	Respiration-asphyxia
2	Aggravated by the slightest exertion	General exertion, physical aggravation
3	Amelioration by open-air	General air-in open-amelioration
4	Amelioration by rest	General-rest-amelioration
5	Stiffness in the cervical region	Back-stiffness-cervical region
6	Pulsating type of pain in the chest	Chest pain pulsating
7	Thirst-Unquenchable thirst	Stomach-Thirst-Unquenchable
8	Appetite-increased	Stomach-Appetite-increased
9	Desire for milk	Stomach-Desires-milk
10	Stool-Constipation, Unsatisfactory stools	Rectum-Constipation-unsatisfactory stools
11	Ailments after the death of her daughter	Mind – Bad news, ailments from
12	Felt sad mainly in the morning	Mind-Sadness, mental depression morning
13	Wanted to live alone	Mind-Reserved

Table-1- Conversion of symptoms into Rubrics

Figure-1- Repertorial sheet-^{^[7]}

REPERTORIAL RESULT

1-Calcarea carbonica-19/9

2-Natrum muraticum-17/8

3-Rhustoxicodendron-15/8

4-Sulphur-15/8

5- Nux vomica-16/7

PRESCRIPTION Calcarea carbonic covered the maximum of rubrics with the highest marks, after consulting Materia medica ^{^[8]}Calcarea carbonica 200 c, stat dose orally followed by placebo 200 /TDS was given for 7 days on 19/03/2023

FOLLOW UP

S.NO	DATE	FOLLOW-UP	PRESCRIPTION
1-	26/03/23	Slight relief in Breathlessness Palpitation and anxiety were same as it was before Pain in chest no relief Stiffness in shoulder and back-slight better No relief in constipation	Placebo 200 /TDS for 15 days
2-	12/04/23	Improvement in all general complaints Breathing now better Anxiety -reduced Restlessness still there Constipation is better -now	Placebo 200 /TDS for 15 days
3-	25/04/23	All complaints are better now Pain in chest started again Restlessness now better Constipation off and on	Placebo 200 /TDS for15 days
4-	11/05/23	Breathing -improved Pain and stiffness also reduced Constipation -better	Placebo 200 /TDS for 20 days
5-	28/05/23	She said that she was completely fine on this visit and advise for Electrocardiogram	Placebo 200 /TDS for 20 days
6	19/06/23	Breathing- 50-70 % improved No anxiety, no restlessness Pain in the chest and stiffness also improved	Placebo 200 /TDS for 15 days

Table-2 ( Follow-up sheet )

RESULT

After taking regular treatment for 3 months patient significantly improved in both physical and mental aspects.

Figure-2 (Before Treatment)

Figure -3 (After Treatment )

DISCUSSION

Heart valve disease is common, referred to as "the impending cardiac epidemic" and is predicted to increase by 2040 and by three times by 2060 as a result of an aging population.^[9] When one or more heart valves are damaged due to heart valve disease, surgery is required. In the present case, patient complaint breathlessness and pain in the chest with palpitation successfully treated with constitutional homoeopathic medicine which was selected after case-taking and Repertorization. Before treatment, her left ventricle Ejection function was 30 %, which was considered moderately abnormal and required surgical treatment, after taking medicine for 3 months her Echocardiogram test showed 50% left ventricle Ejection function, which was considered to be normal. The results showed the positive role and usefulness of individualized homoeopathic medicines in the treatment of such types of surgical cases also. In another case series of three cases of cardiac arrest with different pathology,improvement was remarkable with individualized homoeopathic therapy along with conventional medicine.^[10] This case series demonstrates the efficacy of homoeopathy in ischemic heart disease, showing that post-treatment life expectancy for those affected by coronary artery disease following myocardial infarction is improved following homoeopathic treatment.^[11] To determine the effectiveness of homeopathic treatment in severe cardiac pathology, more research is necessary. These studies should be conducted in a hospital setting and adhere closely to the principles of classical homeopathy to prevent errors. The aforementioned case report demonstrates the effectiveness of homoeopathic medicine for valvular heart disease. The parameters observed indicate an improvement in symptoms while undergoing homoeopathic treatment, suggesting that life-sustaining care for individuals is possible through homoeopathic medicine. This case report suggests that, when administered scientifically according to its laws, homeopathy may be explored for use in cardiac cases also.

CONCLUSION

Homoeopathic medicine treats the person as a whole physically as well as mentally. In this case report we want to show the usefulness of Homoeopathic medicines in such types of surgical cases. We can take Homoeopathic treatment as a preventive and main line of treatment also. After her detailed case taking and Repertorization Calcarea carbonica 200 c was given, and the case was followed for 3 months, Now the patient feels better.

No conflict of interest exists.

Source of funding-None

REFERENCES

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