Case History : A 56 year old woman presenting with shortness of breath

 A 56 year old woman comes to your OPD with complaints of increasing shortness of breath, swelling of feet and tiredness. Her BP is 150/ 100 mmHg.

Your perform a Chest X-ray which is given below:

1. What's are the X ray findings?

2. What is the most likely diagnosis?

3. How would you manage this condition?

4. What other investigations would you like to perform?

Answers given in comments section.

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1. Cardiomegaly / CTR : Cardio thoracic ratio more than 50 %

2. Most likely diagnosis is CCF/ Congestive Cardiac Failure.

3. Management includes: Oxygen , Diuretics such as spiromide +/- intravenous diuresis depending upon severity of CCF and symptoms. Bisoprolol ,Ascard and clotnil to stabilise cardiac function. Salt restriction.

4. Other useful investigations include : Echocardiogram to determine Cardiac status and LVEF and BNP levels in the blood.