Case History : A 45 year old female presents with increasing shortness of breath and bilateral pitting oedema of both legs.

A 45 year old female presents with increasing shortness of breath and bilateral pitting oedema of both legs. Her oxygen saturation is 86 percent. She is afebrile and her inflammatory markers are normal.

BP :145/65 mmHg

Her Chest X-ray is given above

1. What are the chest X-ray findings?

2. What is the most likely Diagnosis?

3. What further investigation Should be performed?

4. How will you manage this condition?

Answers given in comments section.

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Answers :

1. What are the chest X-ray findings?

Cardiomegaly+ peri hilar congestion + Bilateral pleural effusions.

2. Most likely Diagnosis:

Advanced Congestive Cardiac Failure

3. Further investigations :

Echocardiogram

BNP levels

4. Management:

Intravenous diuresis with furosemide 40 mg 8 am, 20 mg 2 pm

High flow Oxygen

Bisoprolol

Loprin

Clopidrogel