CASE OF A 40 YEAR FEMALE WITH PEDAL EDEMA : SHORT CASE

1601006096 

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THIS IS THE CASE I HAVE BEEN GIVEN :

A 40 year old female patient, works at a construction site came to the opd with

CHIEF COMPLAINTS OF :

1. Chest pain since 5 days
2. Shortness of breath since 5 days
3. Pain in the right hypochondrium since 4 days

HISTORY OF PRESENT ILLNESS :
The patient was apparently asymptomatic 5 days ago, the she developed chest pain, non radiating &  increased on taking deep inspiration.
Shortness of breath on & off followed by pain in the right hypochondrium since 4 days

No h/o orthopnea, PND, fever, Cough

PAST HISTORYNot a k/c/o DM, HTN, CAD, Asthama, epilepsy and Tb

PERSONAL HISTORY :

Mixed diet
Appetite normal
Sleep is adequate
Bowel and bladder movements regular
No addictions

FAMILY HISTORY : Not significant

GENERAL EXAMINATION :

• She is conscious,coherent and cooperative
• Moderately built & moderately nourished
• No Pallor, icterus,clubbing,cyanosis,koilonychia and lymphedeopathy

BILATERAL PEDAL EDEMA present, pitting type ,grade 2

• JVP is raised - 7cm


VITALS :

 •Afebrile
• PR : 102 bpm, regular rythm, normal volume, no radio radial & radio femoral delay, condition of the arterial wall is normal.
• RR : 18 cpm
• B.P : 110/80 mm hg, measured in right hand supine position


SYSTEMIC EXAMINATION :

• CVS : S1, S2 + , A pan systolic murmur heard in 4th ICS (left lower sternum) during inspiration

• RS : NVBS, bilateral air entry present, no added sounds

• CNS : 

All higher motor functions are normal

Cranial nerves intact

Sensory system normal

Motor system normal

Cerebellar signs normal

No meningeal signs

• P/A : Soft,  tender hepatomegaly present, bowel sounds heard

INVESTIGATIONS :

Complete blood picture : 

ECG :

COLOUR DOPPLER 2D ECHO


PROVISIONAL DIAGNOSIS : 
 HEART FAILURE  Secondary to Tricuspid regurgitation


TREATMENT GIVEN :

Tab. Nexpro 40 mg OD
Syrup sucralfate 10 mg TID




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