Wednesday, December 15, 2010

EaseMyHealth Doctor in the News!

As a child, Suniti Ghodnadikar never participated in any outdoor sports in school. Unlike her two brothers and sister (who were all well-built), Suniti’s physical growth was stunted and even a small activity would tire her out. “We grew up together and I always used to find Suniti withdrawn and quiet.

Little did I know then that Suniti was a case of Amyloidosis of the heart,” Dr Vijay Surase, cardiologist at Jupiter Hospital.

A Mighty Heart

Suniti was almost leading a normal life till she became a mother in 2000. “A month after my delivery, I almost fainted while doing household chores. I didn’t pay much attention to this episode but the fatigue remained for months.

My legs and abdomen had an abnormal swelling and climbing stairs became impossible. It took immense willpower to reach the terrace of my house.

By then, my neck too became immobile so I started going for the magnet therapy (application of electromagnetic devices to the body for health benefits)” says Suniti.

When it didn’t yield much result, her therapist suggested she get a thorough check-up. After visiting the best cardiologists in Pune and undergoing a battery of tests, she finally approached Dr Surase. “In 2007, I saw her again.

As she walked into my clinic, she stopped for breath after walking a few steps. Her speech was halting and her papers showed she had Primary Pulmonary Hypertension (PPH). It is a rare, dreaded illness and patients suffering from it have a limited lifespan and a troubled life.

Her clinical history was depressing but a glimmer of hope was that she had delivered a baby. Normally PPH patients don’t survive under anesthesia. She did.” After a few tests (abdominal fat biopsy) it was confirmed that Suniti had Amyloidosis and not PPH.

Survival of the fittest
Amyloidosis is a rare but unique group of diseases that share in common the deposition of fibrillar proteins (amyloid) in organs and tissues. “The cause of amyloid disease is related to amino acid substitutions resulting in gene mutations, thus producing defective proteins in tissues.

The amyloid heart looks firm and rubbery and causes different types of rhythm abnormalities,” adds Dr Surase. While the deposition of amyloid is known to occur and presents itself first in other organs of the body, about 50 per cent of patients experience cardiac problems and at least 25 per cent have heart failure.

There is no cure for amyloidosis and most victims die within one-two years. Her doctor says, “The median survival rate is 13 months without treatment and can be extended to 17 months with cyclic oral melphalan and prednisone therapy.

Only 5 per cent of patients survive longer than 10 years and Suniti is one among the few luckier ones. We treated her with Prednisone (steroid) and Melphalan (anticancer drug) and she has developed almost near complete symptom relief. The crucial part is correct diagnosis of the disease.”

A year into her treatment, Suniti underwent a uterus removal operation, as she had another disorder excessive dysfunctional uterine bleeding. If it were PPH, surgery would have been with untoward complications. But now she is fit and active and enjoying life to its fullest.

Her clinical history was depressing but a glimmer of hope was that she had delivered a baby

Signs and symptoms

..of this disease depend on location and size of the amyloid deposits. It may affect any tissue. They may be vague and can include the following:-
- Irregular heart beat (more than one-third of patients have a heart condition)

- Kidney disorders, gastro-intestinal disorders such as perforation, bleeding, slow movement of matter through the GI tract and blockage

- Enlarged liver and diminished function of the spleen

- Diminished function of the adrenal and other endocrine glands

- Skin conditions such as growths, colour changes, purpura (bleeding into the skin) around the eyes and easy bruising

- Enlarged tongue, sometimes with swelling under the jaw, breathing difficulties and sleep apnea

- Lung problems

- Swelling of the shoulder joints (may look like shoulder pads under the skin)

- Bleeding problems



Dr. Vijay Surase is a leading Interventional Cardiologist and is also on the Specialist panel at You can now consult him at EaseMyDocAdvice (click here for profile & Online/Tele consultation)

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