60 yrs female hypertensive. bp170/90. c/o resp distress for 0ne yr. chest clear

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Do PFT first, it's inexpensive and helps to rule out lung cause cardiac inv

Cardiac investigation to follow

ecg shows LVH, treat urinary tract infection with iv antibiotics and other supportive management, rule out non cardiac causes of dyspnea

Also get her KFT done along with serum calcium and serum magnesium
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Treat UTI,control bp,Angiography.

Treat uti having C/ S, rule out renal dysfunction, thyroid disorders, bring BP in normal range.,s.proteins and treat accordingly.
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first teat UTI , correct BP , and than r/0 renal, thyroid, and valvular disfunction , 2d echo for LVD, and copd , i think is this lady having might be having kyphosis ?

It's PH.

Elevated rt dome of diaphragm,cardiomegaly..

Rule out CCF...
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Elevated rt dome with swelling in chest wall rt. Lt dome irregular non homogeneous Lt lower lobe s/o Lt diaphragmatic hernia. Increased intraabdomenal pressure on rt side causing chest discomfort.

LVH (avl) U wave present in chest leads Check S.K, S.Mg Baseline wandering in v4 to v6 so difficult to ruled out strain T wave Hyperacute & fatty in v1 to v3 I will advise serial ecg. Check blood O2, Co2

ABG should be done
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cxr shows cardiomegally, ecg shows LVH, echocardiography is must to rule out cardiac abnormality, urine report shows plenty of pus cells so treat with iv antibiotics or conservative treatment

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