A 77 year old male presented with a six months history of exertional dyspnea and recent onset of chest pain. He denied fevers or weight loss. His vital signs were normal. Physical examination demonstrated dullness on percussion and decreased breath sounds at the bases bilaterally. What is his diagnosis.



Money bag appearance on x.ray chest. ? Pericardial effusion. It can be tuberculous pericardial effusion also as it is insidious. & fever & wt. Loss may be absent. 2Decho will confirm/ rule out pericardial effusion & if yes , paracentesis either diagnostic & if required therapeutic to be done. Pericardial fluid ada levels , microscopy gen. & for afb & culture for afb can tell us if AKT is required.

Cardiomegaly water bottle shaped.pericardial effusion

Thanx Dr Khairat Bhat

DCM, Cardiac tamponade, Pericardial effusion. These are the dds. 2d echo must be done along with blood reports to come at conclusion.

CXR is S/O Cardiomegaly Need more investigations such as 2D Echo,HRCT chest to R/O pulmonary causes too.

Cardiomegaly ?pericardial effusion

pericardial effusion.pitcher shaped heart

Cardiomegaly. Adv Echo

Pericardial effusion-water bottle sign(heart) Difference from cardic enlargement due to faint heart sound as mentioned.Base of lungs may compress by fluid so a patch of dullness may be seen. Ecg-st segment elevation with upward concavity , electrical alternans. Echo-definite diagnosis

Get an ECG, ECHO, labs, if possible CAG to find out the exact cause. With this history it seems like the has developed cardiac tamponade or he has dilated cardiomyopathy.

@Dr. Hemant Adhikari yes cardiac and seems like cokx.Tab.Laghumalini basant 1 bd,Tab.sutsekhar Ra's 2 bd, Tab.Sarparju( shree Ji harna) 1 bd, Tab.Sinocold 2 bd., with warm water
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