For diagnosis

60y/f pt. came with acute chest pains since morning with chest discomfort since 2-3days, shortness of breath since 2-3days, no past any medical history, no history of fever, cough. bp-180/100mmhg , hr-110/min, spo2-90%.

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CXR pa view Rt sided massive pleural effusion Heart is pushed to Lt side with underlying collapse lung Patchy infiltration Lt lung ECG NSR Sinus tachycardia ST elevation in V1 & V2 with reciprocal baseline depression in lead 1,2,avL, avF SV1+RV6>35mm with ST depression with strain Polymorphleucocytosis with raised ESR Iron deficiency anaemia Massive pleural effusion with Pneumonia with ASMI with LVH with Anaemia with uncontrolled HTN Admit in ICU under care of Pulmonologist & Cardiologist urgently
HTN UNCONTROLLED ECG = SINUS TACHYCARDIA LVH WITH STRAIN OCCASIONAL VPC CXR = MEDIASTENAL SHIFT TO LEFT SIDE Rt LUNG COMPLETELY OPAQUE .. LEFT LUNG SHOWING PULMONARY EDEMA D = HYPERTENSIVE ISCHAEMIC HEART DISEASE WITH CHF OPAQUE RT SIDE DUE TO pLEURAL EFFUSION
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Xray shows B/L pneumoniae. Right lung collapse may be due to effusion. May be liver abuses. CT CHEST NEED AND USG WHOLE ABD. MAY ABUSES. FLUID IN RT LUNG so need urgent CT chest and plan ICD in RT lung. Keep on bipap. Do ABG checks k+ also. Suspected Corona and viral. Pneumonitis. .........
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Rt side pl effusion Trechea is in midline Lt side haziness Cardiomegaly Lvh S tachycardia St elevation in lead V1&2 Anaemia Raised est Raised WBC S creatinin? Ccf
Right Side Massive Pleural Effusion with left side consolidation.. D/d Pulmonary Oedema..
POSSIBLY PNEUMONIA PLEURAL. EFFUSION DD PULMONARY EDEMA
Pneumonitis CCF Pulmonary oedema COVID infection
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Hypertensive emergency. Global ischaemia.
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Bp suggest second stage hypertension. Saturation is low british thoracic society suggest SPO2 88 -92 in comatose patient and 94-98 in alert patients.. Unilateral homogeneous opacity right lung, with colapsed left lung Due to massive pleural effusion The EKG shows Sinus rythm with tachycardia heart rate of more than 120 beat /minutes. Cardiac axis is normal. There is S on Vi and R In V6 with T waves inversion on lead V6 and V5 may be left venticular hypertrophy. LVH The patient has low HB. differential of neutrophil signfying bacteria infection Esr is high more than 89 mm/hrs.a sign of inflammation. OVERALL ANEMIA WITH HYPERTENSION HAS POOR PROGNOSIS patient need to be on furosemide iv high dose up to 70mg ACEI low dose to prevent hypotensive crisis. Statin, but renal fuction test must be done before initiating. Fasting blood sugar and hba1cbe tested to rule out Dm
Right pleural effusion ,massive , with mediastinal shift to left Left lung shows fluffy infiltrations ECG- Sinus tachycardia, left atrial enlargement, LVH with strain, Poir progression of R in V1 to V3 Impression Rt sided pleural effusion ,with left sided pneumonia ,? COVID ,? PT Hypertension, LVH , ? Old ASMI , LVF Pleural aspirate analysis for AFB and CBNATT RTPCR for COVID CT chest
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