Dyspnoea in a schizophrenic patient: an unexpected diagnosis

• Published in: Semergen, medicina de familia Vol. 39; no. 4; pp. 231 - 235
• Main Authors: Yagüe Sebastián, M M, Sanjuán Domingo, R, García Noaín, A, Muñoz Albadalejo, P
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.05.2013
• Subjects: Adult; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - diagnosis; Dyspnea - etiology; Humans; Male; Schizophrenia - complications
• ISSN: 1138-3593
• DOI: 10.1016/j.semerg.2012.02.010

Dyspnoea is mainly of cardio-respiratory origin. A diagnosis of psychogenic origin should not be made without having undertaken the necessary complementary tests to rule out any underlying organic cause, even if the patient has a psychiatric history. We present a clinical case with a clinical picture of dyspnoea, in a 30 year-old male of African origin with a history of schizophrenia. Oedemas can also be associated with dyspnoea. Cardiomegaly and hypertrophy of the left ventricle were established, using additional basic tests. The diagnostic confirmation of dilated cardiomyopathy was obtained from the echocardiogram. He was diagnosed in D phase, with decompensated heart failure, which was refractory to treatment, and after several incidents of malignant arrhythmias, the patient died. According to the ACC/AHA classification, the definitive treatment in this phase is the heart transplant. In the present case, urgent intervention was not considered, due to the worsening of the psychiatric pathology and active drug-taking.