Concluded Case

Interstitial Lung Disease with LVH

A 50 year old female presented with complaints of cough with expectoration along with dyspnea on exertion. She brought her reports, an old HRCT of chest suggestive of ILD and a 2D Echo suggestive of concentric LVH. X-ray and HRCT attached here. How to manage such type of patient?

(Edited)

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DIAGNOSIS - ILD+COPD+ LVH So as per all of the opinions received, I will order fresh set of investigations like ESR, CRP, CXR PA view, CBC, 2D ECHO. My treatment regimen would be like this- Tab. Telekast-L H/S Tab. Cardace 2.5mg OD Tab. Lasilactone OD R/C Budamate 200 once daily if no control to twice daily Tab. Erox-CV 625mg TDS if TLC increased Syp. Asthakind LS 2tbsf TDS

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Copd Emphysema Cardiomegaly Ad seroflo & Duoline rota caps thru rotahalers Digoxin & lasix Antibiotics orally Cough expectorant NSAID orally

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Copd emphysema LVH Cardiomegaly Antibiotics Analgesics

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Well, patient is known case of ILD but X-ray chest suggestive of bilateral lower lung opacities? Consolidation? Pneumonia, check her peripheral eosinophil count n ESR and CRP, start broad spectrum antibiotics if complete hemogram suggestive of infection, Nebulisation with duolin and budecort tds, tablet Allegra-M OD, tablet defcort 6mg Bd x7 days with tapering, oxygen inhalation,

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Assess comorbidities, like HTN ,DM , and treat them . ARBs and diuretics for LVH , Underlying CAD to be treated . Antibiotics, nebilusers with long acting beta agonists and steroids, ipratropium ,inhaled O2,

Thank you, Dr Ajeet Singh
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Cardiomegely i& Leht Ventriculr Hypertrophy are well confirmed. Old reports can not be considered conclusive for present epidode dear Dr.Ajeet Singji. Pl insist the pt for fresh investigations

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Ild with lvf give lasix amoxy clav deriphylline r300mgbd expectorent nabulistion with dulin budacort levocet5mg for7days then see improvent do afb for sputum also inhaler

SUGGESTIVE OF I. L. D WITH CONCENTRIC. L. V. H.. CARDIOMEGALY COPD ADVISABLE 1. FRESH. INVESTIGATIONS 2. SYMPTOMATIC MANAGEMENT

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Copd+Lvh MX Duolin+budecort+oxygen neb Inj.lasix Antibiotics Cough syp Tab.levosiz M 1 hs ×7days Tab. Deflacort bd×5 days

Cardiomegaly, COPD with pulmonary plethora? Inflammatory process. LABA LAMA combination diuretics would be great helpful.

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Diagnosis : ILD , COPD , LVH T/t : antibiotics Bronchodilator Nebulisation Diuretics Anti HTN if require

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