Hello doctor, My father is 77 years old and suffering some cardiac issues from the last 8 to 10 years. But recently he has faced some tremendous issue and admitted in the nursing home for thrice. He was suffering from a breathing issue. I am sharing all the latest report which I have received from the nursing home. The nursing doctor told me the different issue at a different time. Sometimes they told me there is a major heart failure and sometimes told there is an issue with high sugar (diabetic). Also, they told me that he was suffering from a bacterial infection. I am puzzled with their comments. Could you please help me and suggest an actual issue with my father?
Hello. I have gone through the reports (attachment removed to protect patient identity). The likely cause for his shortness of breath is heart failure only. However, the infection, high BP may precipitate this heart failure and leads to accumulation of fluid within lungs and shortness of breath. Also, elevated blood sugar is an incidental finding and will come to know on the blood test and will not cause shortness of breath directly. So, the infection may precipitate heart failure in susceptible patients. So, both infection and heart failure needs to be treated. For infection, he needs to be on antibiotics and for heart failure, he has to be on multiple medications including medicines which will increase urination. So, in the treatment chart which you have attached, the diuretics and beta blockers which are two important medicines in his case are not there, so need to discuss with the local doctor regarding these if not having. Also, antibiotic for infection is not mentioned so discuss regarding this if course is not completed.  Next thing, he should have an echo done to look for heart function if not done recently. He needs to have cardiologist consultation for assessment for angiography after his shortness of breath is resolved and an optimization of medicines. So, overall, the treatment he is having is fine but he will need some more medicines for heart failure or ECGabnormalities and will need an echo.