Suspected heart failure with preserved ejection fraction

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Ip no - 201900829917
39 yr old female patient sand weaver by occupation came with complaints of shortness of breath and pedal edema since 4days that are gradually progressive ( grade2-3),she siad she used to stop in between when she was to walk for long distance that gradually progressed to shortness of breath for small distance over period of 4 days and  there also history of  orthopneoa and 2 episodes of PND associated with dry cough that resolved.
No h/o wheeze,cold,fever,burning micturition, decreased urine output

Past history : 
20 yrs back when she was 5 months of gestation she developed pedal edema,facial puffiness and gestational hypertension and she was treated for it.after 5-6 months of delivery her pedal edema decreased.

Then 14 yrs back during 2nd child birth she developed shortness of breath and emergency LSCS was done

K/c/o peripartum cardiomyopathy? 

She also gives history of using antihypertensive  medications intermittently prescribed  by RMP 

Non diabetic,non asthmatic,no h/o epilepsy

O/e - 
Afebrile ,no pallor 
Bilateral pitting type of pedal edema-grade2
Raised JVP + 
No lymphadenopathy,no cyanosis,no koilonychia
Bp-150/100
RR-26/min
CVS- s1,S2 heard 
RS- Normal vesicular breath sounds heard 
P/A- soft 
Cns - normal 

Provisional daignosis- 
Heart failure with preserved ejection fraction 
K/c/o peripartum cardiomyopathy 
Idiopathic edema of women 
Hypothyroidism 


We evaluated her further 
Baseline investigations were sent .
Routine blood and urine investigations came to be normal
TSH -3.85 
Serum albumin -3.1 

Ecg ,2d echo was done and showed normal findings 









Chest x-ray and PFT were also done that showed normal findings 

In view of clinical features and signs of heart failure ;our most probable diagnosis was heart failure with preserved ejection fraction on background of  Hypertension and She was treated with preload reducing drug-lasix,and her shortness of breath and pedal edema subsided gradually.




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