Medical Posting : Case

It's been a long time for me not discussing about the cases i'd seen during my posting..

Actually, this evening i recall back and have a look at my previous posts.. i'm laughing at myself.. i can see the immature side of me and the mature side..hahaha..that's life.. gain experience to make me wiser (ayat G-mah ni )..

First case i saw during my posting this time..the one that i really knew the progress was about :
History

24 years old Malay male, non-smoker presented with gradual shortness of breath and symptoms of heart failure such as orthopnea (unable to lying flat), paroxysmal nocturnal dyspnoea (grasping for breath while sleeping) and ankle edema. Besides, he also become lethargy and reduced effort tolerance for 2 weeks duration. At the same time, he experienced left sided chest pain. He did seek for treatment from the General Practitioner (GP) and was given medication for gastritis (MMT..the white minty syrup). However the symptoms does not resolved.

Investigations

Later, as he knows that the symptoms became worsen, he came to our hospital..and ECG (electrocardiography, a type of investigation to look for electrical activity of the heart) was carried out..and a chest x-ray.. ECG shows that the features of a heart which unable to pump strong enough (low amplitude QRS complex)..and the chest x-ray shows bilateral pleural effusion. Heart border hardly seen. Echocardiography done and revealed the presence of massive pericardial effusion (fluid between the heart wall and the layer that covers the heart, pericardium). Emergency pericardiocentesis (a procedure to aspirate the fluid from the pericardial cavity.
CT scan of the neck, thorax and abdomen were ordered. From the report, there was a huge mass in the midline in the thorax cavity confined the upper, middle and lower part of the mediastinum (in the thorax)..
Two tissue biopsy were done at different time for histopathology examination. The result came back 1 week later..after an urgent tracing..

Diagnosis
Told to have : Malignant Germ Cell Tumor (embryonal carcinoma).
This type of carcinoma commonly occur in male rather in female with the ratio of 9:1.
This patient already gor bone metastasis to the lumbar vertebrae and later was referred to oncologist.

Breaking the news
Before the patient knows about the diagnosis, he did ask me regarding the result. He said that the doctors told him about 'Barah'..and he ask what he's going to do next if the result was true.
I'm as the medical student can't told the diagnosis to the patient. It is bioethics. Only the doctors who manage the patient can do this task.
During the morning round, the same day when the doctor break the news, i was there. I can see the patient's face changed once he knows the result. Can u imagine that??...

As i remember, this was the 3rd time i encountered with the situation. Breaking the news.
The first one involved the patient with Diabetes Mellitus with multifocal lung infections and pericardial effusion secondary to melliodosis. Second case was a 40 years old Chinese man diagnose to have Advanced Unilateral Lung Carcinoma.

See.. no matter at what age, the disease can come without we realized it until it already spread.
At certain range of age, there's certain risk for certain disease. Take good care of ur health.

One of my lecturer told us during teaching with him in KK Kuala Besut :
"Both of my parents got Diabetes Mellitus..i got 80% risk to get the same disease..That's why i do OGTT annualy and always go for medical chack up to look for my lipid profile.."

Just to share with u guys..not to scare any of you..just for reminder..for a better future..