B/l pedal oedema, shortness of breath, since 3-4 months ,no past history..

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ECG shows Sinus bradycardia. Otherwise ECG is normal. Clinically, General examination: look for JVP/Pallor. Is edema pitting or /nonpitting? BP. Respiratory system-Any crepts/effusion ? CVS -Any valvular murmur/Gallop? P/A- look for Congestive hepatomegaly or /ascites? Possiblities: To rule out... -Congestive Cardiac failure, -Valvular heart disease,or CHD - Cardiomyopathy with poor LVEF. -Hypoproteinemia with Anemia, -Renal failure, -Hypothyroidism, -Nephrotic syndrome, -Pleural effusion with ascites. Investigations suggested- 1) Hb% 2) Serum Proteins, 3) Thyroid function test 4) Renal function tests 5) Urine Routine. 6) Urine for Microalbuminuria 7) Urine Albumin /Creatinine Ratio. 8) 2 D ECHO 9) X ray Chest 10) USG abdomen. 11) Serum Electrolytes. Treatment: -Restriction of salt and fluids. -Diuretics. -Specific treatment as per the underlying cause once found after work -up.

very fantastic approach ,thanks Dear.

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low voltage complexes. .sinus bradycardia ..pedal edema. . rule out hypothyroidism and pericardial effusion. .? cardiac tamponade

ECG shows sinus bradycardia.. since patient has dyspnea and pedal edema, my differential diagnosis is heart failure, anemia with CCF, renal failure... rule out hypothyroidism...

ECG shows sinus bradycardia, the possibility of his dyspnoea could be due to cardiac decompensation. The reasons could be manifold like Renal disease, Hypothyroidism, valvular disorder, viral and tubercular cardiomyopathyogy thy

Bradycardia with cardiomegaly CXR PA View Heamogram ESR TFT Lipid profile KFT LFT Urine sample for Routine culture and sensitivity PFT. Suspected of cardiomegaly with LVF

Sinus bradycardia otherwise ECG is normal.Advised Cardiac profile,Lft,kft,Tft,CBC, USG w/A,BSR,cXR, Urine routine,2DEHO,Sr Electrolytes,etc.

ECG normal, advised cardiac profile & X- Ray chest.

get chest x ray and management towards line of pulmonary edema if findind of cxr otherwise in line of chf

ECG Sinus bradycardia, otherwise normal. Needs ECHO , LFT, RFT , Abdominal ultrasound

S.Bradycardia Pt might be in Failure

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