A 75 yr old male presented with chief complaints of difficulty in breathing the previous day.

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A 75year old male labourer by occupation, resident of parda(Nalgonda), presented with the chief complaint of difficulty in breathing.

HISTORY OF PRESENTING ILLNESS 

Patient was apparently asymptomatic one day back and had difficulty in breathing and his relatives took him to a nearby rmp doctor where he was checked for the b.p which was 200/100mm of hg , and was kept on nebulization , telma 40mg  was given to him. Later as there was no improvement in the condition of the patient he was referred to our hospital and brought to the casuality and lost his consciousness. CPR was started and patient was revived after some time and later kept on mechanical ventilator.There are no other associated symptoms in the patient like pain in the chest , any discomfort.

PAST HISTORY

There were no similar complaints in the past.

Patient is not a known case of hyper, diabetes, asthma, coronary artery disease.

FAMILY HISTORY 

There is no significant family history.

PERSONAL HISTORY 

When on normal days

DIET:- mixed

APPETITE :-normal 

SLEEP:- adequate 

BOWEL AND BLADDER HABITS:- regular

ADDICTIONS:- alcohol since 40 years 

                             Smoking since 40 years.

Now patient is kept on mechanical ventilator.

GENERAL EXAMINATION 

 Patient is not conscious, coherent and cooperative and the GCS score was 3 (E1V1M1).moderately built and moderately nourished.

There were no signs of pallor, icterus, cyanosis , clubbing, lymphadenopathy.

There was b/l edema of pitting type.

B.p was non recordable.

Central pulses were weak.

 INVESTIGATIONS 

2-d echo

ECG 

Cbp, Hemogram 

LFT, RFT.

ABG, blood count.

21-11-2022

12 am

6am

11am

PROVISIONAL DIAGNOSIS 

post cpr status with cardiogenic shock that my be secondary to non-st elevation m.i, type 1 respiratory failure.