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Dr. G.K.ShanglooDr. Sharad ShanglooDr. Sunit Shangloo70/59, Rani MandiAllahabad. 211003Uttarpradesh, INDIA.Visit us – www.drshangloo.comE mail- merashah@rediffmail.com sunitshangloo@yahoo.com

Homoeopathic treatment of congenital heart defect

What Are Congenital Heart Defects?

Congenital (kon-JEN-i-tal) heart defects are problems with the heart’s structure that are present at birth. These defects can involve the interior walls of the heart, valves inside the heart, or the arteries and veins that carry blood to the heart or out to the body. Congenital heart defects change the normal flow of blood through the heart.

There are many different types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.Congenital heart defects are the most common type of birth defect, affecting 8 of every 1,000 newborns. Most of these defects are simple conditions that are easily fixed or need no treatment.A small number of babies are born with complex congenital heart defects that need special medical attention soon after birth. Over the past few decades, the diagnosis and treatment of these complex defects has greatly improved. As a result, almost all children with complex heart defects grow to adulthood and can live active, productive lives because their heart defects have been effectively treated.

Types of Congenital Heart Defects

Congenital heart defects change the normal flow of blood through the heart because some part of the heart did not develop properly before birth. There are many types of congenital heart defects. They include simple ones such as a hole in the interior walls of the heart that allows blood from the left and right sides of the heart to mix, or a narrowed valve that blocks the flow of blood to the lungs or other parts of the body.Other defects are more complex. These include combinations of simple defects, problems with where the blood vessels leading to and from the heart are located, and more serious abnormalities in how the heart develops.

Simple Congenital Heart Defects

1. Holes in the Heart (Septal Defects)

The septum is the wall that separates the chambers on the left side of the heart from those on the right. It prevents mixing of blood between the two sides of the heart. Sometimes, a baby is born with a hole in the septum. When that occurs, blood can mix between the two sides of the heart.

Atrial septal defect (ASD)

An ASD is a hole in the part of the septum that separates the atria the upper chambers of the heart. This heart defect allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing to the left ventricle as it should. Many children who have A.S.D.have few, if any, symptoms.

Heart With A.S.D.

Ventricular septal defect (VSD).

A VSD is a hole in the part of the septum that separates the ventricles the lower chambers of the heart. The hole allows oxygen rich blood to flow from the left ventricle into the right ventricle instead of flowing into the aorta and out to the body as it should.

Heart with V.S.D.

2. Narrowed Valves Simple congenital heart defects also can involve the heart valves, which control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart (the aorta and the pulmonary artery). Valves can have the following types of defects:

Stenosis - This is when the valve doesn’t open completely, and the heart has to work harder to pump the blood through the valve.

Atresia -This is when the valve doesn’t form correctly, so there is no opening for blood to pass through.

Regurgitation - This is when the valve doesn't close completely, so blood leaks back through the valve.

The most common valve defect is called pulmonary valve stenosis, which is a narrowing of the pulmonary valve. This valve allows blood to flow from the right ventricle into the pulmonary arteries and out to the lungs to pick up oxygen.

Complex Congenital Heart DefectThe most common complex heart defect is tetralogy of Fallot a combination of four defects: Pulmonary valve stenosis. A large VSD. An overriding aorta. The aorta sits above both the left and right ventricles over the VSD, rather than just over the left ventricle. As a result, oxygen poor blood from the right ventricle can flow directly into the aorta instead of into the pulmonary artery to the lungs. Right ventricular hypertrophy. The muscle of the right ventricle is thicker than usual because of having to work harder than normal This defect prevent enough blood from flowing to lung to get oxygen, while oxygen poor blood flows out to the body.

Normal Heart and Heart With Tetralogy of Fallot

Signs and Symptoms of Congenital Heart Defects Many congenital heart defects have few or no symptoms. A doctor may not even detect signs of a heart defect during a physical exam. Some heart defects do have symptoms. These depend on the number and type of defects and how severe the defects are. Severe defects can cause symptoms, usually in newborn babies. These symptoms can include: Rapid breathingCyanosis (a bluish tint to the skin, lips, and fingernails)Fatigue (tiredness)Poor blood circulation

Abnormal blood flow through the heart caused by a heart defect will make a certain sound called a heart murmur. However, not all murmurs are a sign of a congenital heart defect. Many healthy children have heart murmurs

Tests Commonly Used To Diagnosis Congenital Heart Defects

Echocardiogram

EKG (Electrocardiogram)

Chest X ray

Pulse Oximetry

Cardiac Catheterization

CASE ONE – Baby Manshi Age – 9 month

Radiological findings - X-Ray Chest -dated 5/12/07 Cardomegaly is seen.Echo report dated 9/03/08 IMP- Non restrictive Perimembranous Lt to Rt Snwnt Dilated LA and LV Small fossa ovalis ASD Lt to Rt Snwnt Non restrictive premembranous VSD. VSD gradiant 33 mm hg

Baby Mansi Echogardiograph reeport dt 9/3/2008

Present Problem-

Vomiting 4-5 times a day especially after eating; the things eaten along with allopathic medicines for vomiting is also expelled out. Weight reduced to 4.75 kg.Breathing problem since birth, Heart beat slight fast- Tachicardia. Getting weak day by day, Normal growth is absent.Cannot suck breast milk properly. After birth no complication noticed Only breathing problem noticed Came to know about the disease in 3rd month.Mother suffered no abnormality during or before her birth, after birth she fainted due to excessive bleeding. During 8th month of her pregnancy there was pain in lower abdomen. Excessive heat felt with increased perspiration in summer season with debilitating effect on the child.

Generalities –

Appetite – Normal – Can digest only breast milk other food are vomited.Thirst – Increased Desires cold water.Stool- 4- 5 times a day – curd type – slightly yellowish - undigested food particle in stool.Urine – NormalSleep – Normal- Increased salivation during sleep.

Family History –

Paternal Aunt- alive – Tuberculosis.

Previous homoeopathic Treatment

– Phosphorus 200, Sulphur 200.

Symptoms Used for repertorisation –

Vomiting after eating – Stomach – vomiting- eating- after- agg. (PHOSPHORUS GRADE – 1). Tachicardia – Heart – heart beats- general- rapid. (Phosphorus GRADE -3)( Robin Murphy Repertory).Increased perspiration with debilitating effect- Perspiration – Debilitating. (Phosphorus and Tuberculinum GRADE – 3).(Fedric schroyens repertory)Stool Curdled. (Phosphorus GRADE -3).(Fedric schroyens repertory)Undigested food particle in stool- Stool – food, undigested in stool, lienteric (PHOSPHORUS GRADE – 1, Tuberculinum grade 2).Yellow stool – Stool –Yellow Phosphorus grade -2). Increased salivation – Mouth – Salivation – General, sleep during (Phosphorus grade -2). (Robin Murphy Repertory).Desires cold water (Robin Murphy Repertory – Food – cold drinks, desires –PHOSPHORUS GRADE -1 ).

Result of repertorisation –

On repertorisation Phosphorus came out as a drug of choice followed by Merc Sol, Sulphur, Arsenic Album,

Methodology of selection of medicine

The result of repertorisatinon clearly shows that the drug of choice is Phosphorus but the patient has already taken the medicine for a month with little effect. So we decide to give him Tuberculinum.

The reason for giving Tuberculinum are as follows-

Family history of tuberculosis.Tuberculinum follows Phosphorus well and compliments its action. (Materia Medica by William Boericke Page – 511 – Compare: Tuberculinum follows Phosphorus well and compliments its action)

First Prescription –

Tuberculinum 1000 2 doses at 15 minutes interval was given on 1/5/2008.

Second Prescription –

Patient came on 13/5/2008 with over all improvement so Tuberculinum 1000 was repeated after every 10 days.

Third Prescription –

Patient came on 20/7/2008 with Difficulty in breathing - better by lying on abdomen (Knee chest position) So Medorrhinum 200 two doses at 15 minutes interval was given. (Kent’s Repertory- Page 770 - Respiration -Difficult – Lying on knees and elbow amel.: Medorrhinum grade 3 in the remedy).

Fourth Prescription –

Patient came on 30/7/2008 with no respiratory problem so Tuberculinum 1000 was continued as stated above.

Echocardiography Report – Dated -9.9.2008-

Non restrictive perimembranious VSD. Left to right shunt. Dilated LA And LV. VSD gradiant is 32 mm hg.

Second echocardiography dt 9/9/2008

Fifth Follow up –

As we can clearly see from the report that ASD has being cured and there is improvement in VSD. Now even when she cries there is no blueness of lips. The same medicine was continued

Sixth Follow up –

Patient came on 23.11.2008 with Fever whole night better in the morning, night sweating, exhaustion and great thirst, so Syphilinum 200 two doses at 15 minutes interval was given. Another reason for giving syphilinum is When tuberculinum fails syphilinum often follows, producing positive reaction – Lotus material medica by Robin Murphy – Tuberculinum Relations page 1797.

Seventh follow up –

Patient came on 1.12.2008 with no fever and overall improvement so Syphylinum 200 was given. The medicine was repeated in similar manner after every 10 days and the treatment is still continuing.

Case 2 Ranjana – Age 9 years

Echocardiography report dated -

17/8/2006 – SITUS SOLITUSA/V concordance positive,V/A concordance positiveV.S.D. Size 0.9cm seen.Left to right Shunt. X-Ray –dated- 17/8/06 – Hilar shadow is prominent. Cardio- thoracic ratio is increased.

Case 2 Ranjana Echocardiography dated – 17/8/2006

Ranjana X RAY dated – 17/8/2008

Present complaints -

Her mother suffered cold & cough during pregnancy .She had repeated attack, took allopathic medicines.The child is susceptibility toward cold since birth, watery nasal discharge, sudden spasmodic coughing.Pain in heart region < from exercise. Has to put hand over heart.Palpitation when use to run, climbing and play better by sitting or lying.Dyspnoea < sitting up in bed.She also has attacks of high fever in 1-2 months, with breathing problem and vomiting, Lies still feels better. Relief by drinking cold water, in short intervals just 2sip of water

Generalities –

Appetite – normalThirst – normal Stool – normalUrine – normal but during heart pain urination is scanty with burning.Sleep – normalCraving – saltyMind – increased anger expressive, weeps easily, frightened in dark, hot patient, wear less in winter.

Past complaint –

Vaccination – yes

Family History –G father – dead - heart attackMg mother – alive – asthmaMaternal Aunt – alive – asthmaBrother – alive – arthritis

Symptoms Used for repertorisation

Chest –heart – complaints of the accompanied by – respiration difficult Respiration difficult – heart during pain in, complaints and urinary trouble CHEST - PALPITATION of heart - exertion - agg Chest – Palpitation of heart – sitting – amelChest – Palpitation of heart – lying – amel.Chest – Palpitation of heart – ascending stairs agg.Respiration –difficult –fever- duringRespiration –difficult – sitting up in bed – agg.Cough - spasmodic

Methodology of selection of medicine

On repertorisation Laurocerasus came out as the drug of choice and it fits the patient picture perfectly.

First Prescription

Laurocerasus 200 two doses at 15 minutes interval was given on 24/10/2006. There after it was repeated every week.Medorrhinum 200 two doses at 15 minutes interval was given on 25/12/2007 followed by laurocerasus 200 the next week. The medicine was continued in similar manner.

The reason for giving medorrrhinum 200 was that patient has an attack of Dyspnoea which was better by Knee chest position and there was family history of asthma and arthritis so the medicine was continued every fifteen days to clear it from the route cause.

Echocardiography dated 5/10/2008

Echocardiography report shows sever AS, moderate AR and Normal Left ventricular function.

No VSD Is reported by the cardiologist.

Case 2 Ranjana – second report dt – 5/10/2008

A Healthy Heart Cross-Section

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