Male, 65years. normotensive, non diabetic, non asthamtic c/o Sudden LOc, SOB for 5 hours. His vitals are pulse 136bpm; bp - 110/70; Spo2 84%; R/R-26br/min. Chest-b/l creptts presnt, breath sound diminished on left side. His RBS on arrival was 97mg/dL. planter b/l flexor; pupil normal reacting to light. his CT head was normal. Please diagnosed x ray and if possible make diagnosis.



Mediastinal widening Left basal heziness Possibly pericardial effusion. Rt sided costal and fissural effusion.

Needs further investigation.

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I would like to give Dd as 1 Massive pericardiopleural effusion secondry to any cause like connective tissue disorder 2 already existing cradiomegaly of 4 chamber with cardiac thrombus dislogge And causing pul embolism causing severe breathless Ness with fall in spo2 with collapse and volume loss of lung With hypoxia and another embolism causing TIA loss of conciousness

Hypoglycemia Stroke Hypoxia wth co2 retention To check out ECG: Afib Xray : widening of Mediastinum RT fissure effusion Lf pleural effusion 2d echo to do to rule out epicardial effusion

Pt is having Atrial fibrillation with fast ventricular rate, Give rate limiters and anti arrhythmics to correct. the CT not necessary unless to rule out a CNS physical cause for LOC

Ct was done but it was normal

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Bilateral pleural effusion , may be due to malignancy. Age is also suggestive, so, Rule out ca. Lungs before treatment.

Acute Bilateral pleural effusions, cardio megaly unconsciousness all suggest acute corpulmonale

Medistinal widening On left side "? Double" border cardiac shadow--pericardial effusion A F

Mediastinal widening Pericardial Effusion Cardiac temponade

Af.  Pericardial effusion.  Lft pleural effusion. Tia

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