case studies that relate to understanding heart failure in a
TRANSCRIPT
Case studies that relate to understanding heart failure in a multicultural society 1
Case studies that relate to understanding heart failure in a multicultural society
1Mary
Mary,30yearsold,wasdiagnosedwithheartfailurelastyear.Shelivesinastate-subsidisedhomeandhashadfourchildren.Afewweeksafterthebirthoftheyoungestone,nowagedthreeyears,sheincreasinglybecameshortofbreathonexertionanddevel-opedorthopnoeaandparoxysmalnocturnaldyspnoea.Atpresentshe
hasgrossoedema,ascitesandapleuraleffusion.Thediagnosisofdilatedcardiomyopathyhasbeenmade.
Zindi Zindi,a15-year-oldgirllivinginan
overcrowdedpartofSowetowithherparents,twoyoungerbrothersandanoldersister,hadanacuteillnesswhenshewassixyearsofage.Shedevel-opedseverefeverandhadamigratingarthritisinvolvinglargerjointssuchasherankles,knees,elbowsandwrists.
Thishadbeenprecededthreeweeksearlierbyasorethroat.Attheageof10years,shebecamefatigued,shortofbreathanddevelopedheartfailure.Shewasdiagnosedashavingchronicrheumaticheartdisease,mitralvalvestenosisandincompetence.
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�� Pocket Guide to Chronic Heart Failure
Rosie Rosie,a72-year-oldobeseladyhas
diabetesandheartfailurewithatrialfibrillation.Shetriestoremainactivebygardeningintheirsmallvegetablepatch.SheandherhusbandliveinasmallvillageontheoutskirtsofCapeTown.Theyalsohaveadog.Twogrown-updaughtersliveindepend-entlyinPortElizabeth.Shedeveloped
nocturnaldyspnoeaandankleoedema,beginningfouryearspreviously.
William Williamis60yearsoldandworksasasecurity
agenttakingcareofofficebuildings.At30yearsold,hecametothecityfromasmallvillageintheTranskeiandfrequentlywentbacktoseehiswifeandchildrenwhohadnotmadethemovewithhim.
Williamisaheavysmoker.Hewasdiagnosedwithhavinghypertensionattheageof50.Duetohisworkandlivingconditions,hedidnotcomplywellwiththetreatmentreceivedfromthelocalhospitalclinic.Hedevelopedbreathlessness,andfurtherinvestigationsrevealedthathehad
leftventricularhypertrophy.Hisconditiondeterioratedandheisnowliv-ingwithhisthreesonswhocametothecityaftertheirmotherdied.
George Georgeis65yearsoldandaretiredbankman-
ager.Hehasbeenveryfitinthepastbutbecameawareofchestpainsandsomeshortnessofbreathwhenexercising.Helovesplayinggolf,butfounditincreasinglydifficultbecauseofthelongwalksandhavingtostopattimesbecauseofpainorshortnessofbreath.Heliveswithhiswifeanddaughterinanup-marketpartofCapeTown.Investigationssupportedthediagnosisofcoronaryarterydisease.
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