CPC

1. CPC
GM VI

2. HISTORY
• 50 Year old lady
• C/O Palpitation x 2 weeks. Increased since last 2 days
• C/O Breathlessness on exertion (NYHA II) for 2 weeks
• C/O abdominal distension for 5 days

3. • No h/o chest pain/ cough/ syncope/orthopnoea/ PND
• No h/o decreased urine output
• No h/o fever

4. • K/C/O TYPE II DM for 5 years on Tab Metformin 500 BD
• Not a k/c/o Sys HTN, Bronchial Asthma, TB, Epilepsy, CAD, RHD ,
Thyroid disorder
• POSTMENOPAUSAL

5. ECG

6. On Examination
• Conscious ,oriented ,Afebrile
• BP- 120/80 mm of Hg
• SpO2 96%
• No
Pallor/Icterus/cyanosis/clubbing/lymphadenopathy
• B/L PITTING PEDAL EDEMA +

7. SYSTEMIC EXAMINATION
• CVS – Variable S1, TACHYCARDIA +
• RS- B/L AE+, NVBS+
• P/A – Soft, no organomegaly
• CNS - NFND

8. INVESTIGATIONS
BIOCHEMISTRY PATHOLOGY OTHERS
TOTAL PROTEIN 7.6 FBS 86 TC 7100 CPKMB 14
ALB -4.1 PPBS 133 N72 L21 E1 M6 CPK TOTAL 106
T. BIL 2.3
DIRECT 1.2
UREA 20
CREATININE 0.68
HB 11.4
SGOT 29
SGPT 19
PLATELET 2.49
LAKHS
ALP 108 URINE RE- WNL
Na 134 K 3.3 Cl 101
INR 1.61

9. 2D ECHO
• RA RV DILATED
• MILD PAH
• ADEQUATE LV FUNCTION
• SEVERE TACHYCARDIA DURING STUDY

10. CASE IS OPEN FOR
DISCUSSION