Pulmonary Hypertension with BVF. *Chief Complaints* A 46 yr old female attended Mopd with progressive SOB and productive cough since 1 month with pedal edema since 10 days. No associated fever,chest pain,palpitation,Hemoptysis,Diaphoresis,pain abdomen etc. She is K/C/O Hypothyroidism and Br Asthma. No H/O HTN,DM,Substance abuse. Normal Menstrual Cycle. General Examination normal except B/l pedal edema and prominent Neck veins. Systemic Examination- B/l Infrascapular fine crepts with occasional Ronchi. Routine Ix was advised. Pt attended Mopd with reports showing- CXR - increased CT ratio suggestive of Cardiomegaly with b/l lower zone opacity. Sputum C/S normal flora. Rest blood Ix normal. ECG - multiple VPCs. 2D ECHO- 1. LV function is mildly depressed with estimated LVEF of 45%. 2. IVS and apex are mildly hypokinetic. 3. Right Atrium & Left Atrium are dilated. 4. Right Ventricle is dilated. 5. Moderate Tricuspid Regurgitation. 6. Severe pulmonary hypertension with calculated RVSP of 65mmHg +RAP. 7. Mild Mitral Regurgitation, 8. Trivial Aortic Regurgitation. 9. No LA/LV clot or pericardial effusion. NT Pro BNP not done. Pt started on conservative treatment.

80Y male Chronic smoker since childhood stopped 10yrs back. K/c/o HTN, CAD - S/P PCTA to RCA(10yrs back), COPD - Chronic bronchitis with H/O breathlessness since 1year presented with fever since 3days. Patient is on Nitrolong 2.6, Clopivas AP 75. ECG & CXR attached. Kindly discuss..

pt. age 65 male, present c/o severe breathlessness, fever on and off and cough with yellowish and greenish expectoration since one month. diagnosis & course of treatment?

42 yrs old male pt admitted with complaints of breathlessness and anasarca. .. 1. ecg findings? 2. differential diagnosis?

46 yrs male pt presented with progressive dyspnea, exertional angina and facial edema since last 8days. known hypertensive and on beta blockers. BP 110/80.mhg spo2 94% sr creat 0.9 BSL 98 Hb 8 wbc 4300 plt 1.9 adv Echo, TFT. and started diuretics plz interpret CXR and ECG.