60/F presented with h/o developed difficulty in breathing a/w chest discomfort present while on travel consulted elsewhere and admitted for further management.h/o giddiness + k/c/o T2DM, SHTN, Hypothyroidism on rx o/e conscious, oriented, dyspneic HR: 92/min BP:140/90mmhg. SPO2:94% investigation and CAG done.. Diagnosis and treatment?? is possible trop I elevated with normal coronaries??

44 yr old lady ,not a k/c/o DM/HT/Dyslipidemia c/o dyspnoea on exertion for the past 3 yrs along with 10% weight gain. On examination bilateral pitting pedal edema present more so on the right leg (photo attached) vitals are stable and all the systemic examinations normal. Also attaching the photo of her dry,coarse skin,mostly due to hypothyroidism P.s:Can pedal edema be severe enough to cause medial deviation of the toes??(photo attached) If not what are the reasons for it??

50 yrs old a/k/c of T2DM 15 yr, on OHA, hypertensive for the past 2 yrs on treatment, presents with breathlessness on exertion, abdominal distention, Early satiety 10 days H/O PND 1 episode 15 days back no c/o orthopnea no c/o decreased output O/E facial puffiness+ b/l pitting pedal edema+ lt basal crepts+ investigation urine albumin ++ PPBS 256mg urea 38mg% creatinine 1.91mg% opinion regarding further management

Read carefully and tell me the probable dd 30 yrs female Leucorhoea +,oligomenorrhoea + Retrosternal chest pain with chest discomfort with doe type 2,with uneasiness with severe anorexia with pallor with severe generalised weakness with pitting pedal oedema ,puffiness of face since last two years .dropsy++ O/E bp 110/70 mmhg Pulse 80/minute regular Spo2 92% Ecg gross st-t changes tall r in v1, and avr Jvp raised and visible Cvs -pansystolic murmur +s1s2+ Rs aebe +,clear and equal Already adviced 2decho,cardiologist opinion to rule out - Rhd,mitral valve prolapse,dcmp,subendocardial infarction,ccf Adv:-abg,kft cbc rft thyroid profile,cpk total cpk mb tropnin hrct chest

A 58 yr old male known hypertensive since 10 yrs and diabetic since 3 yrs on regular medication comes to emergency dept with sudden onset of grade 4 dyspnea, with profuse sweating, no chest pain from 2hrs, on arrival to ED patient is tachypneic RR 34,tachycardic 124,BP 110/70mm of hg, SPo2 85 %in RA, GRBS 279 mg/dl, On systemic exam, CNS Pt is conscious oriented CVS s1 s 2 present, RS b/l air entry present b/l crepts, P/A soft, please diagnose and management