The Malnourished Heart: An Unusual Case of Heart Failure

    February 2017 in “ ˜The œAmerican journal of medicine ”
    Sebastian Bruera, Neeharika Kalakota, Ashok Balasubramanyam
    TLDR A woman's heart failure improved after she added vitamins and changed her diet from only cheese chips and cake.
    A 66-year-old woman with no past medical history presented with worsening heart failure symptoms, including dyspnea, edema, and orthopnea, alongside signs of malnutrition such as patchy hair loss, bruises, and gingival bleeding. Her diet for the past 2 years consisted solely of processed cheese chips and vanilla cake, leading to deficiencies in vitamins B1, B6, C, and D. Despite refusing medications, she accepted vitamin supplementation and dietary counseling. After 3 months, her left ventricular ejection fraction improved from <20% to 50%, and her heart failure symptoms resolved. This case highlighted the critical role of micronutrient repletion in treating malnourished patients with heart failure, suggesting that deficiencies in vitamins and micronutrients should be considered in similar clinical scenarios.
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