80F HFmEF ; CAD ; DM ; HTN
Diagnosis ACUTE PULMONARY EDEMA (RESOLVED) SECONDARY TO HFMEF WITH CAD PRERENAL AKI DIABETIS TYPE II HYPERTENSION Case History and Clinical Findings PATIENT CAME WITH CHIEF COMPLAINTS OF DIFFICULTY IN BREATHING SINCE LAST NIGHT. HOPI - PATIENT WAS APPARENTLY ASYMPTOMATIC 18 MONTHS BACK THEN SHE DEVELOPED DIFFICULTY IN BREATHING WITH SWELLING OF B/L LOWER LIMBS WITH FACIAL PUFFINESS AND WAS HOSPITALIZED AND TREATED. C/O DIFFICULTY IN BREATHING SINCE 1 AM LAST NIGHT (GRADE 4 MMRC). C/O CHEST PAIN - DIFFUSE ORTHOPNOEA PRESENT, H/O PND PRESENT NO H/O FEVER, SEIZURES, VOMITING, LOSS OF CONSCIOUSNESS, PALPITATIONS, GIDDINESS, SWEATING, COUGH, COLD. NO C/O DECREASED URINE OUTPUT, FACIAL PUFFINESS, ABDOMINAL DISTENSION. PAST HISTORY: K/C/O HTN SINCE 45 YEARS USING T.OLMESARTAN 20MG BD. K/C/O DM SINCE 12 YEARS USING T.METFORMIN 500MG BD K/C/O CAD SINCE 1.5 YEAR USING CLOPIDOGREL 75MG BD NOT A K/C/O EPILEPSY,TB, ASTHMA. GENERAL EXAMINATION : PT IS CONCIOUS , COHERENT AND COOPERATIVE , MODERATLY