DX: Congestive heart failure

The patient?s primary care medical physician was notified and the patient was sent to a local emergency department for assessment. He was subsequently admitted and treated for a diagnosis of congestive heart failure. The patient reported that 8 lbs of fluid were removed through the use of diuretics the first night. He was released four days later. When the patient returned for chiropractic care, he was in much better spirits stating that after removal of 23lbs of fluid, he was able to perform his daily activities without dyspnea. Medications for his treatment included: Nitro patch (intravenous vasodilation), Coreg (anti-hypertensive), Primivil (zestril) 40m (reduces after load), Glipizise (oral anti-hypoglycemic), Zocor (cholesterol lowering), Glucophage (oral anti-hypoglycemic), Enteric coated aspirin, Lasix (diuretic).

At present, the patient is doing well but still experiences bouts of discomfort due to his degenerative arthritis. His cardiac function is monitored by a primary care medical physician and his chiropractic physician.

This case is important because only 50% are initially diagnosed correctly, but heart failure accounts for 250,000 deaths/year. Congestive heart failure is the most frequent cause of hospitalization in the elderly.

Reference: Shamsham F, Mitchell J. Essentials of the diagnosis of heart failure. American Family Physician 2000 Mar;61(5):1319-27




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