SHORT CASE :
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👉 elevated JVP
A 45 yr old male patient who is a farmer by occupation resident of narketpally came to the OPD with chief complaint of
Shortness of breath since 1 year and
Pedal edema since 3 months
History of present illness
He was apparently asymptomatic 1 year back then he developed shortness of breath which was insidious onset and gradually progressive from grade 2 to grade 4 it aggravates on lying down and on exertion and relieved on medication.
He also complaints of pedal edema which is insidious onset and gradually progressive starting from ankle to whole of lower limbs.
The patient also complains of decreased urine output since 1 month it is insidious in onset and gradually progressive
General examination
The patient is conscious coherent and cooperative Moderately built and Nourished
Pallor is present
There are no signs of icterus , cyanosis , clubbing koilonychia and lymphadenopathy
Bilateral pedal edema is present which is of pitting type.
Raised JVP present
Vitals
Afebrile
BP - 130/80mmHg
PR - 82 bpm , regular , normal volume
RR - 24 cpm
Local examination of Cardiovascular system
Inspection
- Trachea appears to be central
- Shape of the chest is normal
- Apical impulse appears to be shifted from normal position
- No visible scars , sinuses
Palpation
- Trachea is central
- Apical impulse is shifted about 4-5cm lateral to midclavicular line in the 6th intercostal space.
Cardiomegaly is seen
provisional diagnosis:
Elevated JVP due to HEART FAILURE DUE TO FLUID OVERLOAD OWING TO CKD .
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