80F with HFrEF secondary to CAD
80 year old female came with the chief complaints of sob since 3 days, pedal edema since 1 month and decreased urine output HOPI Patient was apparently asymptomatic 3 days back, then she had SOB which is grade II insidious in onset, gradually progressive and progressed to grade IV today morning. orthopnea + , no PND, pedal edema + which is pitting type fever + low grade yesterday which is relieved by medication. PAST ILLNESS known case of CKD, hypertension and DM II since 15 years known case of CAD 1 month back. Advised PTCA but was not done TREATMENT HISTORY Linagliptin 5mg OD Amlodipine 5mg OD On cefpodoxime 200mg BD PERSONAL HISTORY Married Housewife Normak appetite Vegetarian diet Rrgular bowel movement Decreased micturition Teetotaler GENERAL EXAMINATION no signs of pallor, icterus, cyanosis, clubbing, lymphadenopathy Oedema of feet + Vitals: Temperature : 98.2 PR : 116/ min RR : 20/ min BP : 130/70 mmHg Spo2 : 83% at room air Grbs : 144mg% SYSTEMIC EXAMINATION CVS : S1 S2 + ,