78 female breathing difficulty restless known htn on examination lungs wheeze na + 121 bp stable renal profile normal ecg wnl

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Cardiomegaly Rt atrial enlargement .Pulmonary conus is prominent. Lt border of heart is straight s/o mitral valve pathology. Rt side fibrosis of lung . There is loss of volume of both lungs. The lungs have got honeycomb appearance s/o chronic lung disease ie may be interstitial lung disease. It is cor pulmonale? Do echocardiography . Treat with nebulization of bronco dilatory drugs Iv lasix . Correct hyponatremia by oral NACL.

The CXR shows cardiomegaly with deviation of trachea to the right suggestive of fibrosis in right upper lobe.The lung fields show honeycombing pattern which is either due to interstitial lung disease or fluid in the septal spaces suggestive of early LVF.The wheeze can be due to COPD or early LVF what used to be known as cardiac asthma.Treat with nebulised bronchodilators and IV frusemide.Hyponatremia should be corrected slowly by oral NaCl.

cor pulmonale. exclude long standing history of copd. large cardio megaly present. loss of volume of bilateral lungs.

Cardiomegaly with pulmonary koch's, advised AKT and cardiac profile.

Rt upper lobe para tracheal mass,tracheal shifting,with hyponatremia(paraneoplastic syndrome SIADH).may be lymphoma / malignancy.CT chest to exclude.

Dilated cardiomyopathy

cor puimonale