A 72 year old man comes to your OPD with complaints of swelling in both feet, and shortness of breath on climbing stairs.

A 72 year old man comes to your OPD with complaints of swelling in both feet, and shortness of breath on climbing stairs. Also complains of fullness in his right hypochondrium.

His pulse is 68/ min

BP is 126/75 mmHg.

Resp rate is 17/min.

Examination shows bilateral pitting oedema.

CXR given below:

1.What is the most likely Diagnosis?

2. What is the cause of fullness in Right hypochondrium.

3.What are the findings on Chest X ray.

4. How will you manage this patient?

Answers given in comments section.

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1. Most likely Diagnosis:

Congestive Cardiac Failure

2. Cause of Fullness in Right Hypochondrium:

Congestive Hepatomegaly.

3. X ray findings:

Cardiomegaly

Peri hilar congestion

4. How to manage such patients:

1. Diuretics

2. Oxygen

3. Salt restriction.

4. Daily weights.

5. Fluid restriction of 1.5 litre.

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