a 27 yr female , SOB grade 4 since 5 days,her hb is 6.7gms ,b/l pedal. edema, 2d echo was EF 45% ,RF positive, ESR 70 1st hour ,now she is on O2 inhalation through mask 3 lit,inj piptaz 4.5 gr and inj moxiflox,inj dexamethasone,inj pan 40, any modifications regarding medication and management, advised 2units PRBC,pleural taping was unsuccessful,??? thankyou



Enlarged heart.. With bilateral pulmonary edema with no pleural effusion.. Should be the diagnosis.. Cause of cardiac failure... Is it DCM?.. Needs an ABG.. to assess the PCO2.. No indication of steroids like dexamethasone if a pure case of cardiac failure... Add nebulisations... CPAP.. and diuretics..with other supportive measures..

cardiomegaly with bilateral lower zone infiltrates low EF for age do BNP look for cardiomyopathy if married take detail history of pregnancy or abortion this might be post partum cardiomyopathy manage with diuresis blood products other supportive care and CPAP

thank you sir

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X ray reveals cardiomeagaly. Pleural effusion rt.it is anaemia with cardiac failure. Pl add inj lasix 40mg od.she must be having hypoproteinaemia too.we have to analyze the cause of anaemia. Is it nutritional/ deficiency vit B12 or iron deficiency. As per the type of anaemia correction has to be done

cariomegaly with b/l lung infiltrat s/o pul edema with severe anaemia....duration of anaemia...??tachycardia induced cardiomyopathy

more than 6 months, tachycardiac 135/ mins,

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It's pulmonary oedema. Adv: Take an Ecg to r/o MI In dis case Inj. Lasix 40 mg iv bd IV antibiotics n iv Ppi Neb. Asthalin Q6H Neb. Ipravent Q12H Cpap Supportive care

its congestive heart failure d\d could be peripartum cardiomyopathy or valvular heart disease or post viral myocarditis common in this age group of females

This is a case of CCF as the doctors in forum pointed out... chest x ray shows pulmonary oedema...usually HB of 6.7 GM % doesn't present with CCF....unless patient is having concomitant Thyrotoxicosis or AF with FVR or sepsis or underlying cardiac disease like RHD or viral myocarditis.... since you have done RA factor which turned out to be positive...I would like to ask for ANA and coombs test as well

Also ...I feel aggressive antibiotic therapy is not warranted here...moxiflox alone would have been enough.

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Severe anaemia with cardio measly with b/l pulm congestion. S/0. Pulm edema . No pleural effusion. Correction of anaemia / investigate for anaemia. PCT/ IV lasix.. No steroids. Low EF r/o. Cardiomyopathy

Sorry also to do ABG And in treatment part can giv blood products depending on Hb

what is cbc report....spo2 on air....b/l besal so it goes in favor of ARDS n pedal oedema it my b secondary due to anemia....do BNP to R/o cardiac cause

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