35 years female No H/O DM EPILEPTIC Asthma C/O breathlessness ghabrahat Unable to climb or walk for a distance due to breathlessness since 2 to 3 months taking telma 40 Dx and Rx?

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D/dx-Hypertesion with CAD. Psychogenic cause. Advise-CABG.2d echo. Cbc esr.serum blood urea serum creatinin.blood suugar ecg. Continue hypertensive drugs Add on drugs after report. Psychological counselling of pt.

Copd, Emphysema, hyperactive airway disease, Bronchial Asthma

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Perihilar opacification seen possibly lymphadenopathy. Consider sarcoidosis lymphoma TB as a DDs. Adv CT thorax and further work up.

PL NOTE IN HISTORY ----------------------------------------------- IT IS MENTIONED SHE IS ONLY HYPERTENSIVE ( TAKING TELMISARTAN 40 MG ) IN HISTORY IT IS MENTIONED SHE HAS NO H/ O DM BRONCHIAL ASTHMA OR EPILEPSY SO SHE HAS NO MULTIPLE COMORBIDITIES SHE HAS NO BRONCHIAL ASTHMA TO ACCOUNT FOR HER SOB

Lady is with multiple comorbidies Her complaints seems to be psychological Xray chest is NAD Assess by ecg 2decho Sos pft Psychological counseling

Thanx dr Dinesh Gupta
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HYPERTENSIVE HEART DISEASE I CARDIOMEGALY LV TYPE = CXR PAH ? MORGAGNI HERNIA ADV = ECHOCARDIUM BLOOD = PROBNP

Rt paracardiac hazyness, Rt sided hilar enlargement,

Thank you doctor
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Hazziness inferior right lobe Need further evaluation with ekg and echo

POSSIBLY... ..VALVULAR HEART. DISSASE ADVISABLE... ECG ECHO..

रोगी कि L.F.T. and K.F.T and C.B.C की जांच कराएं ताकि उचित परामर्श दिया जा सके।

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