28 Y /M PT. CAME TO MY OPD WITH COMPLAINTS OF WEAKNESS, ,LETHARGY, ,GIDDINESS, ,DOE, ,SINCE 7-10 DAYS, ,T-AFEBRILE, ,BP --90 /60, ,HR --92/MIN, ,SPO2--96 @ ROOM AIR, ,HE COMPLAINTS OF "PALPITATIONS ",,CHEST --MURMUR ++,NO DM /HTN /BA, ,NO ANY ADDICTION, ,,BELOW R THE REPORTS ATTACHED, ,PLZZ suggest RX & MX, ,THANKS ,,

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Huge cardiomegally with murmur what type of murmur & what about 2d echo ECG shows anti wall ischemia so these reports r needed for right suggestions & what u have described pt may be having valvular heart disease & leading to CCf so can be treated by Diuretics Digitalization Antiboitcs followed by further work out & observation

Agree with your observations, and once pt is stabilised may require valve replacement after a detailed work up .
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It seems to be a case of chronic severe MR. X ray : cardiomegaly with LV contour, LAE, prominent PAS & PVH. ECG- NSR, LAE , LVH ( v5 R > 25mm) ECHO: huge LA, flail AML, normal EF ( 60%) , @Dr. Rohit Thakarebut there is a discrepancy - LV dimensions is normal? The recent symptomatic deterioration should be evaluated - Possibility- IE, excessive diuretic therapy , anemia, intermittent AF, MVP, FLAIL AML WITH SEVERE MR - DETERIORATE RAPIDLY AND in 10 years 90℅ cases undergo surgical intervention,or dies . Management. Surgical intervention is indicated for symptomatic patients. EF < 60℅ . In this case identify and treat the precipitating cause, if symptoms persists - surgical intervention.

Dr.Rohit Thakare is wrongly tagged.
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Case of Huse cardiomegaly ,due to flail AML,causing severe MR leading to CCF,atrial enlargement (bifid p wave,7.02cm) causing low BP ,palpitation. Not appeared to be a case of RHD,appeared to be rupture of AML chordae tendinae due to sudden blow or strenuous activity in later part of his life. Pt to be stabilised by diuretic(loop),degoxin,oxygen etc before repairing the chordae when size of heart will reduced somewhat. MVR perhaps not required nor prophylactic penicillin.

Bi atrial enlargement, lvh, prominent pulm vasculature, mostache sign, patient symptomatic unlikely not having PAH, needs valve replacement at any cost

Cardiomegaly with MR with preserved EF ..Give digoxin diuretics with anticoagulant & repair to be needed..

Looks like MS With MR with hypotension.Admission in ICU for further work up.

Severe MR with normal EF. Patient will require mitral valve repair.

Cardioangiography need

X ray reveals rt atreal enlargement. Mitralization ecg reveals AF.Looks like Rheumatic valvular heart disease. 2d echo will clinch the diagnosis. Before that cardiac auscultation if u have Mid diastolic murmur at mitral region loud P2. Systolic murmur at tricuspid region s/o.TR. HE needs control of cardiac failure inj lasix 40mg iv Betablockers. Control of AF

Bifid P wave with cardiomegaly. Mitral valve disease. Treat with diuretic,digoxine and ace inhibitors. Once patient is stabilised then go for mitral valve surgery. Long term anticoagulant and antibiotics should also be considered.

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