Epigastic pain :: 3 days
Pedal oedema:: 3days
Epigstric pain associated with sob ::2 days
H o p i
Pt. Apparently asymptomatic 3days back
Then she developed sudden onsetof epigastric pain without any vomiting or loose stool history, which subsided with medication.
Pedal bl oedem is pitting type extending upto shin since 2 days not associated with any decreased urine output .
H/o immobilization present
No h/o decreased urine output, fever,cough, palpitaions, chestpain ,headache, orthopnea,pnd.
KC of HTN was on medication . Bit discontinued it.
Not a kc of dm,CVA, epilepsy,Asthma.
Surgical history:
Her lower left limb went under Recurent operations.
She had femur fracture in 2005,implant was placed
Implant removal done in 2019 and 6days after implant removal she did weight bearing so she again had fracture
Implant is placed again.
Patient is a vegetarian by diet, she has loss of APPETITE regular bladder and bowel movements,no allergies and no addiction s
No family h/o DM,HTN ASTHMA,EPILEPSY.
CvA,TB.
Moderately built and moderate nourished
V i t a l s:
Temp: 98F
Pr: 126 bpm
SpO2 :78 % on room Air
Rr : 26cpm
Bp: 110/70
Grbs : 168
SpO2 on 2lt O2 =98%
Dx
?Right heart failure
secondary
to cor pulmonale
?HFpEF
?PTE sub massive
Kc HTN
Tx
Inj LASIX 40mg BD
Iv fluids Ns with OPTINEURUM@75ml /hr.
O2 inhalation @2-4lit/min to maintain spO2 >92%.
T. TELMA 40 mg po OD
Advice: GRBS 6th hry CHARTING .
I N V E S T I G A T I O N S:
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