a 70 year old male with corpulmonale secondary to COPD

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' 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.

A 72 year old male handloom worker occupation, resident of village near choutuppal presented to casualty with

Chief complaints of :

Bilateral lower limbs swelling since 1 to 2years (on and off) associated with SOB.

Patient was apparently alright 20 years back when one day he had sudden on set of chest pain left sided associated with sweating and palpitations then he went to local hospital and told he had an heart problem (?CAD) then was using regular medications.

Since 2 years patient developed bilateral pedal edema (on and off) initially till ankle then progresses till above knee since then he had bilateral lower limb pains, easily fatigued, SOB on execution. Since then he had his work and 1 year back he was devastated by his wife death due to acute coronary syndrome.

Occasionally patient is having cough with sputum as his smoking consumption is increased.

Now since 15-20 days patient have bilateral pedal edema above thighs a/w SOB at rest and generalised body pains.

No H/o giddiness and herbal medication.

Smoker since 50 years (10 to 15 beedis/day)

Occasional alcoholic since 40 years.

N/K/C/O DM

O/E

Bilateral pedal edema + (above thighs)

CVS- S1 S2 + (raised jvp)

RS - bae + B/L IAA crepts

P/A - soft and nt

CNS - NAD