Ms. MS(21 year old) came for the treatment of severe depression since Dec. 2011.
She was suffering from migraine since Feb. 2012.
She had congenital heart disease – tricuspid atresia.
Clubbing of nails, cyanosis, breathlessness due to cardiac problem.
She also complained of pain in all joints, specially hip joint, knee joint and ankle.
She is a very short tempered girl and does not get along with paternal aunt who has psychiatric problem.
INVESTIGATIONS
| DATE | INVESTIGATION DONE | RESULT |
| 3-2-12 | 2D- ECHO COLOUR DOPPLER STUDY | CHD (S,D,S) – Tricuspid atresia- type 1B-? S/P Glednn shunt.
Moderate sized secundum ASD with R>L shunt. Hypoplastic RV. Normal LV function. Patent Glenn shunt. |
| 14-6-12 | S. IgE | 58.63 |
| 22-6-12 | S.Serotonin | 38.0 |
| 7-7-12 | Allergy Test | Pollen, Dust, Dust mite, Pigeon Droppings, Latex, Urad Daal, Milk, Prawns |
| 21-7-12 | Haemoglobin | 20.2 g/dl. |
| 21-7-12 | S. Calcium | 8.84 mg/dl. |
| 21-7-12 | S. Uric acid | 9.97 mg/dl. |
| 21-7-12 | Urine – Albumin | present (++) |
| 21-7-12 | 25 OH Vit. D | 20.10 ng/ml. |
FOLLOW UP
| DATE | COMPLAINTS |
| 24-6-12 | Breathlessness, Pain in all joints, gets angry for trivial reasons. Weeps after fighting with aunt. |
| 10-7-12 | Breathlessness better. Pain in knee joints and ankle joints. Anger decreased. Weeping less. |
| 25-8-12 | Breathlessness much better, pain in knee joints and ankle joints better. Anger decreased, no fights with aunt. |
| 13-9-12 | Anger much better. Cordial relation with aunt. |
