Case of cardiomegaly with Hypertension

A 58 year old obese female presented to the OPD Chief Complaints Her complaints were of dyspnea on exertion and weakness History Known case of uncontrolled Hypertension on amlodep AT Investigations Advised for 2D Echo Management I had prescribed her Telista-MT 40/25, and Dytor 5 mg OD, and she had significant relief after it Your opinion and line of management for such kind of cases

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Cardiomegaly with Pulmonary Hypertesion with LVH, AORTIC KNUCKLE CALCIFICATION, DO 2D ECHO, LIPID PROFILE, TROPI-I/II, RFT, BT,CT, PTINR, APTT, CONTINUE TELMA MT, RAMIPRIL, TAB. DYTOR 10 MG OD, TAB. ABIWAYS, CARDIAC AND PULMO OPINION

Extensive lung fibrosis with prominent bronchovascular markings bilateral Cardiomegaly+ with prominent rt cardiac border in kco hypertensive pts needs to subject 2decho to r/o RHF with PAH and pericardial effusion Your line of treatment is good enough but needs to follow 2decho

Thanx dr Vipin Bihari Jain
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Left ventricular hypertrophy. Control her BPs. Stress test. 2 D echo. Review

Chest xray appears wNL albeat increased vascular marking.Cardiac silhouette is normal,how yuo come to conclusion of cardiomegaly ?For that ECG and Echocardiography are required. If treatment givwn by you are beneficial and relief symptoms ,it is ok if high BP controlled but required adjustment with other drugs which must include one diuretic. Exertional dyspnea need evaluation of heart for IHD.If lipids abnormalities and diabetic needs treatment modification also.

Prominent bronchovascular markings Aortic knuckle calcification seen Retrocardiac irregular opacities seen possibly central hiatus hernia. Adv Echo CD. HRCT thorax if clinically significant.

Underexposed X Ray chest Haziness in both lung field is because of underexposure Normal chest x Ray Combination of diuretic, beta blocker and Ace receptor blocker is good combination I would have considered calcium channel blockers in stead of beta blocker

Obviously Cardiomegaly due to hypertension Blood pressure to be monitored and treated Supportive treatment

Thanks Dr. Dinesh Gupta,Dr. Kute Ankush, Dr. Pushker Bhomia, Dr. Rajendra Rai
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CXR..STUDY .. CARDIOMEGALY .. PULMONARY CONGETION .. NEED'S .. CARDIAC PROFILE ..

Tnx Dr Rajendra Rai
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SUGGESTIVE. OF CARDIOMEGALY CENTRAL. HIATUS. HERNIA. ?? NEEDS FURTHER. EVALUATION

Advise-1-FPG and blood sugar pp 2hr. 2-serum lipid profile 3-serum thyroid profile. 4-coronary angiography. 5-2D echo and color doppler Rx-1-Tab Telmiduce-H 1od. 2-Tab Ramipril 1.25mg 1od. 3-Tab Resplash 1od. Rest depend on awaited reports Inj lasix +inj deriphylline iv slowly O2 inhalation stat may be required in emergency.

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