52 male ,k/c/diabetes,HTN,IHD on treatment.c/o cough since 3 weeks. hemodynamic parameters stable. RS bil fine crepts and wheezing present. interpret CXR.

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Cardiomegaly with B/L pulmonary edema( Batwing appearance).Stabilise with diuretics.Control HTN with NTG infusion.Check for end organ failures.Control DM/ HTN with Oral drugs.Start Cardiac remodeling drugs Like Spironilactone/ ACE inhibitors/ Betabloclers may be used if IHD +/ Heart rate can be controlled with Ivabradine.

Acute rt cardiophrenic angle suggestive of pericardial effusion & bilateral basal haziness indicates pul edema , putting these things together most likely CCF & with the back ground of dm,htn& ihd adv coronary angio , TFTs 2d echo ,diabetic , hypothyroid cardiomyopathy in this setting should also be kept in mind.

Mild faint haziness in rt base with cardiomegaly and picture of pulmonary oedema with basal crepts and comorbidities suggest copd with sec chest infection r/o pneumonitis bronchovascular markings are wuite prominent

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Cardiomegaly with large bottle shaped heart? Pericardial Effusion Heart Failure leading to b/l haziness in lower zones... Kerley B lines s/o pulmonary edema Diuretics with Nebulization

What are the prerequisites before starting ACE Inhibitors (S.K levels ,Urea / Creatinine) .What else . Please discuss.
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Cardiomegaly with pul odema Diabetes lead to htn Htn lead to cardiomegaly Htn lead to ihd All above lead to pul odema Pul odema lead to cough So diuretics are mainstay of treatme t

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CCF Diuretics ACE inhibitor Beta blocker Broad-spectrum antibiotics Mucolytic GTN OHA Low salt diet Diabetic diet Do cbc ,rft ,lft to see secondary other organ involvement

cardiomegaly with bilateral lower zone haziness s/o cardiogenic pulmonary edema

Cardiomegaly with LVH B/L lower lobe haziness due to pulmonary edema

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CARDIOMEHALY BAT WING OPACITY BOTH LOWER ZONES SUGGESTIVE OF CHF

Cardiomegaly with pulmonary oedema

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