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


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.
It's a case of Left ventricular hypertrophy with pericardial effusion.
Bilateral pleural effusion Case of acute LVH
Ischaemia induced LVF
Old age, known case of CAD but the present symptoms indicates some neurological involvement--- Probably CVA involving either extra pyramidal or cerebellar system, Vomiting & Aspirations pneumonia. -Next possibility could be seizure and aspiration pneumonia?
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

View 2 other replies

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
Left synpneumonic pleural effusion ? PULMONARY embolus , Acute LVF Suggest ECG to rule out arrhythmias, ECHO, and CT angio to rule out PE
Left cardiophrenic angle obliterated Possibly Pericardial effusion.. Urgent Echocariograpyhy required
GTC, tracheal deviation to lt , ??LLZ collapse due to aspiration
Load more answers