cardioloy, skin

55 yrs female k/c/o RHD,post MVR on acitrom since 10 yrs, developed this kind of rash since two days, platelets 2lakh, inr 2.32,counts 17000,deranged LFT, please interpretate diagnosis, thanks

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RHD, MVR , X-ray Sternal sutures seen, Cardiomegaly with straightening of left border, right pleural effusion, CCF Purpuric rashes Consider Infective endocarditis, with vegetation on the Prosthetic mitral valve. ECHO , blood culture from 3 separate sites, Anti biotics, prosthetic valve may have to be removed .

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Sternal sutures present. Bilateral tenting of domes, pleural effusion and reticulonodular opacities. Enlarged cardiac shadow with straightened left cardiac border. Carinal angle wider. Mitral valve disease with PAH.

DISSEMINATED INTRA VASCULAR COAGULATION.IN WHICH THE PROTEIN THATCONTROL BLOOD CLOTTING ARE OVER ACTIVE. SINCE HE IS USING ACITROM(ACENOCOUMAROL) SHE IS USINGPROLONGED TIME. THAT PREVENTS ABNORMAL CLOTS. INR IS ABNORMAL THAT CAUSES INCREASE RISK OF BLEEDING AND IT HINDERS THE WORK OF CLOTTING FACTOR. RX MY ADVICE IS CHANGE THE DOSE OF ACITROM. AS TLC IS SHOOT UP CONTROL WIT BROAD SPECTRUM ANTIBIOTICS

Thanks Dr Sabista Naaz
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Sternal sutures in situ. Cardiomegaly. Bil reticulonoduler infiltration seen. Bil pleural effusion seen. Adv PT INR

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CXR CARDIOMEGALY UPPER LOBE VEINS PROMINENT BILATERAL PL EFFUSION = SUGGESTIVE C H F LEUCUCYTOSIS PURPURIC SPOTS ( PLATELETS ( N) INR ( N,) ADV = BACTEC BLOOD CULTURE BACTERIAL ENDOCARDITIS IS POSSIBLE CAUSE

Cardiomegaly.bilateral basal haziness and pleural effusion.straightening of L heart border.sternal sutures visible.ecchymoses visible.bt,CT, PT to be estimated.

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Cardiomegaly C C F Valvular heart disease Ad 2 DEcho

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Infective endocarditis Cardiomegaly CCF Bilateral pleural effusion Advise 2DECHO,PT INR

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Infective Endocarditis with Pleural effusion, CCF

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Cardiomegaly with bilateral basal haziness with pleural effusion

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