1601006008 Short case

 1601006008


This is an online e logbook to discuss our patients deidentified health data shared after taking her/guardian's signed informed consent

Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs

This E log also reflects my patient centre’s online learning portfolio and valuable inputs on the comment box is welcome.


Case:A 46yr old female,housewife resident of Nalgonda came to hospital with chief complaints of shortness of breath since 5days 

History of present illness

  She was apparently asymptomatic 5days back then she developed shortness of breath which was insidious in onset ,gradually progressive,aggravated on lying down and relieved on medication.

Associated with orthopnea,wheeze,paroxysmal nocturnal dyspnea 

Anasarca since 5days and cough with expectoration since 5days which is insidious in onset

Past history

K/c/o Copd since 12yrs and is  on inhaler

 General examination 

Raised jvp 

Respiratory examination 

Inspection-normal

Palpation- normal

Auscultation - bilateral  decreased breath sounds and bilateral rhochi and crepitations present at infrascapular,infra axillary areas














Cvs examination 

Inspection -normal

Palpation

-left parasternal heave

-Palpable p2

-apex beat 5th ICS lateral to mid clavicular line

Ascultation

-S1,S2 present

-Loud p2

-no murmurs 








Findings

Right atrium and right ventricle dilated

RVSP 85mmhg

Severe TR with PAH







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