50 year old female with SOB

25th November ,2020


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Case presentation:


A 50 yr old Women came to casualty  on 24-11-2020 at around 4pm  with c/o of SOB and cough since 2hrs

who was normal till day before yesterday night .. suddenly developed

 SOB-not associated with chest pain and palpitations

 for which she was taken to RMP ..some medication and O2 inhalation given (medication no records) ..her SOB was relieved followed which she was asymptomatic till 4 pm in the evening..then again she developed SOB ,then she was brought to our hospital for further evaluation.

No H/O palpitations , chest pain , syncopal attacks ,

Fever , cold , burning micturition, constipation , diarrhoea ,orthopnea , PND

She is a k/C/O HTN , DM  since 10yrs and on regular medications 

PAST HISTORY-

10 years back she had similar episode for which for angio has been done

k/c/o dm,htn since 10yrs on regular medications of

Tab Metformin 1000mg + Glimiperide 2mg( gluconorm G2 forte) tab teneligliptin 20 mg

 Tab Atorvastatin 20mg

Tab clopidogrel 75mg

Tab pregabalin and nortript( pragabalin NT)


PERSONAL HISTORY- 

diet- mixed

appetite - normal

sleep - adequate

bowel and bladder - regular

No Addictions


ON  GENERAL EXAMINATION -

Pt is Conscious, coherent , cooperative

No sign pallor , icterus, cyanosis, clubbing, lymphedenopathy , edema


VITALS-

Temperature- 98.4 F

pulse - 90bpm

RR - 18cpm

BP- 130/90 mmHg

Spo2 - 96%

GRBS -86 mg/dl


RESPIRATORY SYSTEM-

BEA+

coarse crepts B/L in all areas


CVS- 

S1 S2 heard in no murmurs 

 

Per Abdomen-

soft , non tender, no organomegaly


CNS- 

No focal neurological deficits


INVESTIGATIONS DONE-

HAEMOGRAM


URINE FOR KETONE BODIES

DAY 1 ABG

DAY 2 ABG

RFT


LFT


APTT


PT, INR

TROPONIN I



ECG






Chest X Ray




CT chest

CT chest done : 2.6 x 2.6 nodule noted in the left lower lobe with irregular margins with B/L pleural effusion R>L ...with CORADS 1




PROVISIONAL DIAGNOSIS-

SOB under evaluation

Anterior Wall MI ( LAD territory)

B/L mild pleural effusion

Hypoalbuminemia and hypokalemia


TREATMENT GIVEN-

Tab ecosprin 150mg OD

Tab clopitab 75mg OD

Tab Atorva 40 mg BD

Tab Met XL 25mg BD

Tab Pan 40 mg

Inj lasix followed by dytor 10mg









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