7 yr pt came with c/o SOB after slight exertion or running, symptoms from early childhood, that's why not going even to school, on auscultation systolic murmur heard with thrill in all areas, belong to low socioeconomic class and used to consult quacks or pharmacist only, discuss possible dx considering ECG, CXR etc attached below..

72 years old female with profound anorexia and nausea since 20 days visited the opd. Managed with ppi's but to no relief. Urine output is good. No any physical signs. Patient is a known case of bronchial asthma, well controlled on inhaled steroids and salbutamol. Vitals are WNL. Please interpret the EKG.

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

25 years female patient presented in OPD with breathlessness on exertion, relieved by rest, palpitation since 2 years. not taking any treatment. O/E: P=108/min regular, BP: 110/60mmHg, CVS: MDM at mitral area, loud P2 at pulmonary area, PSM at tricuspid area. R/ s : NAD, please discuss the chest Xray , ECG findings and further line of management.

45 years old male smoker presented with Exertional Breathlessness, cough, wheeze . Examination revealed HR 76/min, BP 120/70 mmhg, Mild darkish fingertips, he has short systolic murmur . Lung few scattered rhonchi. ECG& X Ray taken. What is your impression and how do you approach