1. SOB since 20 days
Pt was apparantly asymptomatic 20 days ago. Then she developed breathlessness which was gradually progressive in nature from grade 2 to 3. Aggravated on exertion and on supine position. Relieved in sitting position. Orthopnoea + not a/w wheeze. No c/o chest pain, cough, pnd, vomitings, abd pain or decreased urine output or fever.
Not a k/c/o DM, TB, asthma, epilepsy
K/C/O HTN since 1 year (on regular medication)
H/o hospitalisation 20 days back I/v/o breathlessness and fever.
O/E
Pt c/c/c
BP 110/60 mmHg
PR 140bpm
RR 45 cpm
SpO2 92% in RA
GRBS 150mg%
CVS S1 S2 +
RS
Dyspnoea +
Wheeze -
Trachea central
NVBS
On auscultation - BAE +, decreased breath sounds in L IAA, ISA, AA, crepts in L IAA
P/A
Soft, non tender, BS+
CNS No FAD
-ECG
-CXR
-2D ECHO
1. Tachycardia
2. Moderate TR with PAH
3. Sclerotic AV
4. EF 56%
5. Dilated RA, RV, MPA
6. IVC 1.6 cms
LAMA NOTES
Patient and the attenders have been explained about the risk and complications and poor prognosis in their own understandable language i.e. Telugu. Complications such as sepsis, cardiogenic shock and need for intubation and mechanical ventilation and sudden cardiac arrest. Despite explaining these complications, attenders are not willing for further management. Hospital, doctors or the staff are not responsible for further condition of the patient.
