41 f,k/c/o bronchial asthma, presented with exertional dyspnea,off and on chest pain since a week.HR 130,BP 140/80,spo2 94%. RR 25,RS-occ crepts and wheezing. Routine lab reports normal except sr creat 2.2. 2D echo sugg mildly dilated RA RV, PASP 60mmhg,EF 45% plz comment on cxray and ECG,possible diagnosis and further management.

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ECG SINUS TACHYCARDIA CLOCKWISE ROTATION AQRS + 165 RBBB RVH CXR CARDIOMEGALY REVERSE BATWING SIGN SUGGESTIVE OF PNEUMONIA RT LOWER ZONE DIAPHRAGMATIC HERNIA LT SIDE

Thank you doctor
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Ecg Low voltage in chest leads RAD LPHB IRBBB S.TACHY T wave inversion in v1 to v3 Check S.Trop X-ray Haziness in lower lobe of both lungs P. E must be ruled out

Cor p Asthma + renal dysfunction To rule out autoimmune disorders..

Thank you doctor
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X-Ray chest straightening of L border of heart. Non homogeneous opacity both Lower zones . Prominent Bronchovascular markings R. Diagnosis-Corpulmonale .

CxR..Rv type cardiomegaly,prominent pul.conus.haziness rt.lower zone EcG..Sinus tachycardia,low voltage,R Axis,RBBB,Poor progression R in lat.leads Corpulmonale with consolidation R.Lower zone,Azotemia Antibiotics,diuretics,bronchodilators Usg for kidneys,urine,electrolytes

Corpulmonale with CCF & pul embolism, wedge shaped opacity along rt chest.Adv ddimer & ventillation perfusion scan ,

Chest X-ray s/o RMZ paracardiac haze, rotation present In view of high PASP and dilated RA/RV, CTPA to be done to rule out pulmonary embolism

Thanks sir,sr creat is 2.2,is it still advisable to do CTPA? Can any nonionic preparation be given?
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Sir in our institution we usually do low CM DE CTPA protocol with lower limb Doppler with nephrology clearance....it gives equal results as compared to standard CTPA