85 year old lady who is a known case of CAD,UA,breathlessness now c/o sudden onset of fatiguability,breathlessness,3 episodes of vomiting along with alleged history of involuntary movements of limbs,uprolling of eyes and froathing of saliva from mouth.o/e, PR-85,SPO2-84, fine basal creps present,old ECG changes of T inversion in cjest leads and 1,AVL....suggest your diagnosis. @alona @aiswarya

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From the above history it looks like a case of acute LVF. may be due to recent acute coronary event.

Xray shows bilateral pleural effusion. May be due to previous heart failure.
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eeg,xray is necessary for teatment

Bilateral pleural effusion Case of acute LVH

History is suggestive of acute LVF due to CAD. Xray shows b/L homogeneous opacity with b/L obliteration of costophrenic angles suggestive of b/L pleural effusion

Cerebral thromboemboli from old MI.

Emboli from ventricular aneurysm ?

X ray chest suggestive of LVH with pul.edema.Seizure activity is to be explained.Full diagnosis should be Ht with CAD with LVF with thromboembolism with CVA.Should get CT brain while managing LVF.

LVH with pleural effusion with CVA
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LVF with pleural effusion ?pulmonary embolism

It's a case of Left ventricular hypertrophy with pericardial effusion.

CCF and hypoxia encephalopathy

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