Feeds:
Posts
Comments

Posts Tagged ‘att in heart failure’

Tuberculosis is rampant in our country ( of course in any developing country ). Many of the patients who are referred  for cardiac  failure has history of pulmonary  tuberculosis.

In our echo lab we handle  100s of  patients every month from the regional TB sanatorium  . While the clinical presentation  mimics  COPD ,  many of them  have be severe bi-ventricular dysfunction  in echocardiography   and  bulk  of them satisfy the criteria for dilated cardiomyopathy . So what are we missing ? or guessing ?

The following paper  which  finds a  strikingly similar observation  . . .   is important for many reasons

  • It  comes for a prestigious Institute from India (PGIMS Chandigarh)
  • It strongly  suggest the link between DCM and tuberculosis
  • It also tells us both can be completely curable.

We know cardiac failure is a relentlessly progressive disease . We also know ,  certain forms  of DCM are reversible  especially infectious and toxic ones .Whenever we ask  our residents (Bitten by the western bug !)   for causes of reversible cardiomyoapthy  they promptly rattle out exotic conditions  like selenium deficiency and cobalt cardiomyopathy etc ,

  we tend to forget  “a big possibility  of   tuberculosis”  as cause for reversible cardiomyopathy.

  Students are not be blamed ,we have never taught them to think  in Indian  perspective !

Finale

DCM is a biggest  cardiac problem in our country next only to CAD. While our country men suffer , we are perennially happy to  label  them    as  idiopathic DCM   ,  even as   we  continue to  loose our  precious time  every day ,   in  ballooning dubious lesions  in  hi -tech cath labs  and help  fill the corporates coffers !

I entirely agree with the authors ,   DCM due to Tuberculosis  is  a hugely under-recognised entity  in a country with over  12o0 million people. So , youngsters  are  argued to find  answers to this   burning  issue . (* I am afraid how many of us are aware of such  an important  article published from India. )

We propose to under take a study from from Chennai  tuberculosis research center about this. Any body wishing to fund this project ?

How does tuberculosis affect heart muscle ?

Will be posted  soon .

Read Full Post »