Concluded Case

55ys male,nonsmoker non HTN non DM,presented with cough fever dyspnea since a week. mild hemoptysis since 2 days. O/E bil wheezing and basal crepts heard more on left. spo2 93% BP 100/80 mmHg Rv neg , BSL 110, CBC creat reports, cxray CT thorax and ECG are attached. plz interpret and discuss.

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Concluded answer
bronchiectasis with pneumonia. CAG sugg of double vessel disease. plan PTCA ,once infection subside.
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Xray suggestive of emphysematous look tubular heart plus bl mini consolidations.......ecg so lad lvh acc to voltage criterion....plus st depression in ant lat leads.....seems loke ischaemic changes......probably lvf vith lvh n ischaemia....echo n engymes vill make things more clear.....plus confirm diagnosis of pulmy koch also.....sputum afb c/s....cbc cbnaat vil confirm that also......
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Heart is tubular xray chest shows opacity lt base with obscured lt cp angle ecg shows lt axis with st-t depression in 1 2avlv2v3v4v5v6 suggest LVH r/o inf wall ischimia . History suggest hemoptysis cough fever with basal crepts and wheez with hyperinflated rt lung suggest lt lung pathology d /d consolidation 2 pleurisy 3 lvh
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Iron deficiency anaemia Polymorphleucocytosis B/L infiltration?reticulonodular more in Lt lower zone Lt lung>Rt lung Lt cp angle obliterated ? pleural thickening Anterior wall ischaemia with LVH with strain Tubular heart COPD with IHD R/O PTB, Pneumonitis
Bronchiacstasis bilateral ,more on left side with fibrotic changes , ECG shows ischemic changes + pt has got iron def anaemia ,adv sputum AFB & c/s & gram stain. Lvh difficult to comment in presence anaemia , only 2d echo.can be conclusive of it.
ECG 1,2,V1 V2 V3 V4 V5 V6 ST _ T inversion Anteroseptal lat wall ischemia Do 2D echo Left cp angle obliterate with infiltration Hyperinflation of both lung with tubular heart with LVH ? EMPHYSEMA COPD with pneumonitis
CXR- LT cp angle obliterated may be due to thickening of pleura LT MZ/LZ bronchiactesis- causes hemoptysis TC -11100/cmm s/o 2nd infection ECG - LVH with strain - advice echo
Pleural thinking Lt fibrotic changes seen both sides of lung. Tubular heart, opacity Lt base with obliterated cp angles. Pleurisy ? Rule out any eventuality.
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ECG LVH WITH STRAIN CXR POST TUBERCULAR SEQUALE PLEURAL THICKENING LT FIBROTIC CHANGES BOTH SIDES MICROCYTIC HYPOCHROMIC ANAEMIA MILD LEUKOCYTOSIS
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Fibrotic. Changes..both sides.. PLEURISY...?? L V H... ANAEMIA... Mild. Leukocytosis.. Consolidation..
bronchiectasis with pneumonia. CAG sugg of double vessel disease. plan PTCA ,once infection subside.
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