CASE OF A 40 YEAR OLD WITH PEDAL EDEMA


Friday, 30 April 2021

CASE OF A 40 YEAR FEMALE WITH PEDAL EDEMA 



This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.

Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.

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

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

No h/o orthopnea, PND, fever, Cough

PAST HISTORY :  Not 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 

• JVP is raised 



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


SYSTEMIC EXAMINATION :

• CVS : S1, S2 + , No added murmurs

• 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, non tender, no organomegaly, bowel sounds heard

INVESTIGATIONS :

Complete blood picture :



ECG :


COLOUR DOPPLER 2D ECHO


Diagnosis:Right sided heart failure



Comments

Post a Comment

Popular posts from this blog

PNEUMONIA WITH DIABETIC KETOSIS

Image
April 30, 20                                       This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment   40 year old male, labourer by occupation, low socioeconomic status from narketpalli came to opd with  Cheif complaints: Breathlessness since 1month Fever since 10 days Chest pain since 4 days History of present illness: Patient was apparently asymptomatic 1 month back, then developed Breathlessness which was insidious onset which used to be grade 2(MMRC)   and progressed to grade 4 since last 4 days with no postural or diurnal variatio
Read more

NSAIDS INDUCED NEPHROPATHY WITH METABOLIC ACIDOSIS WITH CKD WITH HTN(1MONTH).

Image
65 year old male patient came to OPD with  C/o of shortness of breath grade 2 to grade 3 according to a NYHA classification since 15 days C/o bilateral pedal edema(on and off since 2 yrs) and complain of decreased urine output since 2 months  C/o decreased appetite 65 year old male who is farmer by occupation   was apparently asymptomatic 14 years back doing all his routine activities and then he met with an RTA and sustain low back ache for which he was conservatively treated for six days and then discharged which is followed by recurrent back ache for which he took NSAIDS for 10 years in nearby hospital followed by herbal medication . Two years back he noticed bilateral pedal edema and went to local hospital and treated conservatively and then pedal edema is on and off. 2months back he noticed decreased urine output Since 15 days he complain of shortness of breath grade 2 to grade 3 K/c/o Hypertension since 1month ( on tab atenolol 10mg,irregular medication) Not a k/c/o di
Read more

70 yr old male with altered sensorium

Image
70 year old male farmer by occupation came to the casualty with sudden onset of a aphasia since yesterday night . patient was apparently asymptomatic till yesterday then he woke up from bed at 11 p.m. to go to washroom and fell from bed and his attenders  observed aphasia (sudden onset) and he is unable to wake up from the floor.  no history of trauma to the head, no involuntary micturition and defaecation. H/O fever 5 days back not associated with chills and rigors and not associated with nausea and vomiting,took treatment from local RMP. No H/o pedal edem,SOB,burning micturition.  H/o tingling sensation of bilateral upper limb and lower limb since 1 month    not a known case of asthma ,TB epilepsy   known case of diabetes since one year and hypertension since one year and on irregular medication   alcoholic occasionally(last drink 1week back) and smoking (1chutta/day) since 45yrs. Personal history :  Married  Diet - mixed  Appetite - normal Sleep - adequate  Bowel movements : regu
Read more