Dyspnea It is normal with all of us when we exert excessively.. But Dyspnea that is greater than expected with the degree of exertion... is a symptom of disease. Most cases of dyspnea result from asthma, heart failure and myocardial ischemia, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia, or psychogenic disorders.. Below mentioned are the pathological causes of Dyspnea by Organ System…. CARDIO-VASCULAR…     Pulmonary edema Acute valvular disease Myocardial infarction Cardiac tamponade    Heart failure Angina Constrictive pericarditis RESPIRATORY… Acute exacerbations or persistent chronic asthma Acute exacerbation or persistent chronic obstructive lung disease Pulmonary embolism Pneumothorax Pneumonia ARDS Anaphylaxis    COPD Asthma Interstitial lung diseases Pulmonary hypertension Malignancy (tumor related obstructive lesions and lymphangitic spread) Pleural effusions Sleep apnea Foreign body aspiration GASTROINTESTINAL/HEPATIC Acute liver failure and its consequences Abdominal distention of various causes Ascites Portopulmonary hypertension Hepatopulmonary syndrome RENAL CAUSE Acute or chronic renal failure and its consequences HEMATOLOGICAL… Hemorrhage    Anemia NEUROMUSCULAR     High cervical cord lesions Trauma to phrenic nerves    Central apneas Myasthenia gravis Myopathies Amyotrophic lateral sclerosis ENT cause Vocal Cord Dysfunction Laryngeo-tracheal obstruction PSYCHOGENIC  BREATHLESSNESS I hope this list of causes will be HELPFUL to diagnose the aetiology of DYSPNEA…

33 y/o female with chest pain, difficulty on breathing, and heart palpitation. diagnosis???

A 62 year old male admitted to the emergency having collapsed. He has a pale complexion, weak pulse and a blood pressure of 75/40. while Examining the chest its found that on the left there is reduced chest expansion, a stony dull percussion note and absent breath sounds. What is the diagnosis and management for this case.

A middle-aged male was found down. EMS was able to get the patient to climb onto the ambulance by himself, then during transport he became less responsive. They briefly could not find pulses, and gave a short period of CPR with ROSC, but he did not require a shock. They gave Narcan without improvement. An oral airway was placed and BVM oxygenation provided. The patient arrived unable to provide any further history. BP was 180/100, HR 130, Oxygen saturations 84%. He was intubated. A bedside ultrasound showed poor global function and B-lines of pulmonary edema. Here was the first ECG:

30yr primi lscs done in govt hospital ,after 5 hrs no urine output ,ARF ,all needfull done ,but useless no response Bp120/50,p100,rr16/min,oxygen saturation 89-90,forcefull breating Pls advice needfull