ashfaq

63 year old female with c/o shortness of breath since 3 days, History of present illness: patient was apparently alright 7 years back then she developed shortness of breath, chest pain - retrosternal then incidentally she was diagnosed with sinus venosus ASD, managed conservatively , since then she developed shortness of breath initially grade 2 to grade 3 associated with chest pain/midscapular pain radiating to axilla, orthopnea +, paroxysmal nocturnal dyspnea+ since 2 days K/c/o sinus venosus ASD diagnosed 7 years back N/k/c/o HTN, DM, Asthma, Epilepsy Loss of appetite since 3days Constipation since 3 days Teetotaler alcohol consumer O/E: Patient is conscious,  coherent, cooperative Pallor, clubbing present No icterus, cyanosis, lymphadenopath, edema Temperature- afebrile Pulse rate- 85 bomb Bp- 120/80 mm Hg Respiratory rate- 20 cpm Personal history: CVS: S1 S2 heard Murmurs present RESPIRATORY SYSTEM: Dyspnea+ Centrally positioned trachea Vesicular breath sound

DR.NAVYA(INTERN) DR.CHETANA(INTERN) DR.ABDUL RAHEEM (INTERN) DR.ASHFAQ(INTERN) DR.SRAVYA(INTERN) DR.GNANADA(INTERN) DR.CHARAN(PG1) DR.VAMSI(PG1) DR.SUSMITHA(PG2) DR.ADITHYA (PG3) DR.PRANEETH(PG3)  DR.PRAVEEN NAIK (ASS.PROF) DR.RAKESH BISWAS(HOD) This  is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Here is a case i have seen: A 60 year old male patient was apparently asymptomatic 2 months back then he developed shortness of breath . On exertion , which progressed to grade 4 associated with orthopnea and paroxysmal nocturn

DR.ASHFAQ(INTERN) DR.CHETANA(INTERN) DR.ABDUL RAHEEM (INTERN) DR.NAVYA(INTERN) DR.SRAVYA(INTERN) DR.GNANADA(INTERN) DR.CHARAN(PG1) DR.VAMSI(PG1) DR.SUSMITHA(PG2) DR.ADITHYA (PG3) DR.PRANEETH(PG3)  DR.PRAVEEN NAIK (ASS.PROF) DR.RAKESH BISWAS(HOD) This  is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Here is a case i have seen: 72 year old Male patient who was apparently asymptomatic 10 days back came to the hospital c/o pain in the lower abdomen which was insidious in onset, gradually progressive, squeezing type, non radia