70 year old female came with chief complaints of shortness of breath since 5 days
C/o shortness of breath since 1 week C/o generalised weakness since 1 week Pt was apparently asymptomatic 1 week back then she developed shortness of breath , grade 2, aggregated on exertion , gradually progressed to grade 4 . H/ o orthopnea present , no PND.No seasonal variation,no diurnal variation.No h/o fever,cold,cough.no weight loss.no pedal edema. Past history: K/c/o HTN K/c/o HFrEF Not a k/c/o Dm2,CVA,CAD,epilepsy Personal history: Diet: vegetarian Apetite: decreased Bowel and bladder: regular Sleep: disturbed GENERAL EXAMINATION: Patient is conscious,coherent and cooperative, moderately built and malnourished Pallor: absent Icterus: absent Cyanosis: absent Clubbing: absent Lymphadenopathy: absent Pedal edema: present VITALS: Temperature: 98 .2F Pulse: 124beats/minute Blood pressure:120/80mm Hg Respiratory rate:20cpm Systemic examination CVS - S1 S2 heard R/S - No wheeze Diffuse crepts present no palpable mass, Trachea- central Ve...
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