70/M with DCMP

 70/M patient  presented with complaints of 

Shortness of breath since 15-20 days .

Gradually progressive 

Patient says that he has   disturbed sleep and experiencing severe shortnessof breath at around 5am daily since 20 days ( no leading question was put ) 

Orthopnea + 

Patient has noctuira since 20 days .

No seasonal variation of Sob ,no chest pain ,no palpitations ,no chest tightness . no sweating,

No pedal edema ,no decreased urine output.

No cough, cold ,no wheeze ,no abdominal distension .

No Bowel and bladder dysfunction.


Patient is chronic alcoholic and smoker since 30-40 years .

Patient is non diabetic ,non hypertensive ,no  CAD,CVA.


On examination : 

No pallor , icterus , cyanosis ,edema or lymphadenopathy ,

Cvs examination 

No jvp ,carotid pulsations present 

Inspection - 

Apex impulse visible at 6th ics 

No parasternal heave ,no visible sinuses ,scars 


Palpation - apex impulse -6th ics just lateral to mid clavicular line 

No thrills 


Auscultation - S1,S2 heard no murmurs 


He was admitted yesterday and was put on lasix infusion till today .

Patient is symptomatically feeling better .




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