62 year old woman with breathlessness

-




A 60 year old woman presented with the complaints of 
Dyspnea at rest since 15 days
Left lower limb swelling upto knee since 10 days
Reduced urine output since 10 days
A 60 year old woman who used to work as a farmer 3 years back, mother of 5 children (3 daughters and 2 sons - 1 son expired, patients attendant reluctant to discuss the cause) presented to the casualty with the complains of dyspnea on exertion since 1 year. 1 year back she visited Osmania hospital for these complaints after which she has been put on medications which she has been using on and off (not documented). Since the past 4 months she has been experiencing dyspnea at rest on and off, whenever she experiences dyspnea she visits a hospital, takes medication and then stops taking them.
Since the past 15 days she has been experiencing dyspnea at rest and 10 days back she has had a trauma to her right 2nd toe after which she developed left lower limb swelling along with reduced urine output. She was taken to a local hospital where she was told that she developed left lower limb cellulitis.
Pallor+
PR - 120bpm
BP - 120/60mmhg
RR - 27cpm
Spo2 - 96% on Room Air 
Cvs - 
JVP raised
Parasternal heave +
Palpable P2
Visible apex beat
Apex beat in 6th ICS , 1cm lateral to MCL
Epigastric pulsations +
On auscultation - Loud S1 +
S2 split +










Comments

Post a Comment

Popular posts from this blog

DAYS IN NEPHROLOGY

-
Image
My day started on 9th May 2020 with Morning rounds of my patients in Nephrology ward with my intern. At around 11am , A Patient presented to the casualty, A 60 year old man, Farmer from a local village, Occasional Alcoholic since 25 years and Chronic Beedi Smoker since 25 years, who was diagnosed to be hypertensive and diabetic 6 months back.  He apparently had no medical issues until an year back when he started getting breathless on walking for a few miles and he gradually started experiencing breathlessness even on rest, on & off though he had no complains of associated chest pain, palpitations, nausea, vomitings or associated giddiness. One fine morning, before he started for work he observed his feet were swollen upto his ankles for which he decided not to consult a doctor and managed by resting for a few days. Over the next few days the swelling in his feet gradually progressed up to his thighs and it alarmed him when he had developed facial puffiness. He also sta...
Read more

Brain Stem Strokes

-
Image
BRAIN STEM STROKES: Here's a brief discussion regarding the Ventral Midbrain Syndromes which I've gone through on 9th & 10th of May. Will update regarding the other syndromes in my further posts. The posterior surface of midbrain has a Tectum portion & a Tegmental portion. The Tectum portion consists of Corpora Quadrigemina & 4th cranial nerve where as the Tegmental portion comprises of Floor of the 4th ventricle, Median Sulcus, Facial colliculus & Sulcus Limitans.  Three important Ventral Midbrain Syndromes are  : 1) Weber syndrome 2) Claude syndrome 3) Benedikt syndrome These occur due to the involvement of P1 segment of Posterior cerebral artery.  Posterior Cerebral Artery is divided into P1 & P2 segment ( proximal & distal to Posterior communication artery)  1) Weber Syndrome:   The lesion is at the level of crus cerebri, here you can see the location of the cor...
Read more