SUSPECTED HEART FAILURE WITH PRESERVED EJECTION FRACTION

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Ip no-
65 year old male patient presented to OPD with complaints of
1. Pedal edema since 10 days
2.shortness of breath since 10 days
3.fever and cough since 10 days

Patient was apparently asymptomatic 10 days back then he developed pedal edema that started from lower limb and extended to trunk and then to face .
No h/o decreased urine output
Shortness of breath since 10 days ,patient is unable to walk  for long distance and stops in between ,history of wheeze present ,no seasonal variation , chest pain ,no orthopnea ,no PND ,no h/o chest pain
History of Intermittent low grade fever Since 10 days associated with productive cough- non foul smelling,mucoid in consistency
No h/o loose stools,vomitings,pain abdomen ,burning micturition

No h/o DM,HTN,ASTHMA,EPILEPSY,CAD
 Risk Factors:
Chronic alcoholic - used to drink 160 ml/day for 40 years ,stopped 1 month back
Chronic smoker- used to smoke 1 pack of beedi/day for 40 years and stopped 1 month back

On examination :
Patient is afebrile ,conscious
Bilateral pitting edema -grade 2
Pulse rate-100/min,regular in rhythm ,normal volume
BP-140/90 mmhg
RS- bilateral aid entry present with wheeze all over the chest
Cvs - normal heart sounds
P/a -distended with everted umbilicus

Provisional diagnosis :
Heart failure ? Cor pulmonale




                         

                     
                   

  •                                     2D echo showed normal ejection fraction with normal chambers and no regurgitations 
  • Treatment : 
  • Patient was put on Preload reducing agents and nebulisations 
  • Improved symptomatically .           

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