Hello Doc,

This patient had suffered a Pulmonary thromboembolic episode in the past. This patient seems to be in Cardiac failure. His Pulmonary hypertension which is seen as PASP 97 mm of hg, is due to fluid congestion.

You can treat this patient and get him out of this problem if you follow the following rules perfectly.

1. Fluid intake should be restricted below 1 litre a day for next 90 days.
2. Calorie intake should be restricted below 800 Kcal a day
3. Patient should consume food only if hungry and should maintain a gap of 10 to 12 hours in between 2 meals.
4. Ask the patient to completely refrain from Milk, Rice, Wheat and Sugar for next 90 days
5. Patient should follow complete NBM for 24 hours once a week for next 12 weeks.
6. Tab Lasix 40 mg should be continued for next 30 days twice a day at 7 am and 1 pm.
7. Virechan once a week will be beneficial
8. About 14 to 21 sittings of HFRT will be helping the patient to improve the force of contraction of his heart. To start with perform the said PK in Propped up position
9. Ask the patient to sleep in night in propped up position only
10. Salt intake to be restricted to 2 gms a day, not more than that.
11. Ask the patient to perform 30 min of Bhramari Pranayam every day.
12. Repeat 2 D echo every 30 days to measure the PASP. At normal, it should be below 20. In a months time we expect the PASP to reduce down to 60. Once it comes down below 50, patient will be out of danger.

All the best! Follow all the above steps and you will win.