Obesity, heart failure, and pneumonia: a case report

Obesity is a widespread chronic disease of the 21^st century, characterized by excess accumulation of adipose tissue and weight gain. These patients have a significantly increased risk of cardiovascular disease and vulnerability to respiratory infections. Cardiorespiratory complications remain the leading causes of death. The combination of bilateral pneumonia (BP) and heart failure (HF), developing in the context of obesity, significantly worsens the prognosis.

Brief description. This case presents describes a 60-year-old patient with obesity, bilateral pneumonia, HF, and hypertension. The main complaints were shortness of breath on exertion, cough with nummular sputum, and palpitations. The history included myocardial infarction. Body mass index was 36,8 kg/m², oxygen saturation (SpO₂) — 86-89%. In addition, there were high respiratory rate, moderate cyanosis, reduced breath sounds, dry and wet rales. Blood pressure was 140/80 mm Hg, heart rate — 100 beats/min. Computed tomography revealed infiltrative and reticular changes in both lungs. Echocardiography revealed a decrease in the left ventricular ejection fraction to 20% and dilation. Elevated brain natriuretic peptide levels were noted. The diagnosis of bilateral pneumonia was established based on clinical and paraclinical data. Treatment was administered according to clinical guidelines. After 15 weeks, computed tomography showed following improvements: improved left ventricular (LV) contractility, decreased LV size. However, there was a decrease in glomerular filtration rate.

Conclusion. This case reflects the atypical onset of bilateral pneumonia in a patient with obesity and HF: the disease manifested primarily with physical and imaging signs in the absence of laboratory markers of inflammation. This emphasizes the need for advanced diagnostics and individualized therapy, as the presence of pneumonia increases the risk of renal and cardiorespiratory complications.

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