52 year old female with heart failure with reduced ejection fraction ~32% with k/C/o HTN since 17 years


Unit 5 : admission on date :12/2/2021
Dr. Praveen Naik assoc professor 
Dr. Natasha mam( Pg Y3) 
Dr. Zain Alam( Pg Y2) 
Dr. Sashi kala ( Pg Y1) 
Dr. Shailesh Patil( Pg Y1) 
Interns
Dr. Shriya 
Dr. Sridevi
Dr. Sowmya
Dr. Anjali Vishwas
Dr Mourya
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. 

Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. 

This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.

C/o shortness of breath since 2 months 
C/o pedal edema since 2 months. 
Hopi- patient was apparently asymptomatic 2 months back then developed pedal edema(pitting type) upto knee which was sudden in onset and gradually progressive in nature. 
H/o shortness of breath since 2months grade 3 to 4 according to NHYA classification associated with bendopnoea occasionally chest heaviness not associated with palpitations, orthopnoea/PND.
No H/o fever, headache, giddiness, cold, cough, syncope, burning micturition, chest pain, vomiting. 
K/C/o htn since 17 years on regular medication ( tab losartan-H 50/12.5mg) no H/o DM 
H/o MI 8 years back not on any medication. 
H/o similar complaints in the past 4 months back for which she was given medication for a nearby medical Hall




Rx day 1 
Inj lasix 40mg iv bd 
Check weight daily 
Tab losartan -H (50/12.5mg )
Bp pr monitoring 2 nd hourly 
Tab carvedilol 3.125mg po od 
Strict input output charting 
Salt restriction < 2gms / day 
Fluid restriction <1 litre/ day
Day 2 bp-110/80mmhg
Pr-84bpm regular
Cvs-muffled heart sounds 
Rs-nvbs+ no crepts 
Grbs -107mg/dl
I/o-550/500ml
Wt-73kg
Rx-inj lasix 20mg iv stat 
Tab losartan-h (50/12.5) 
Tab carvedilol 3.125mg po od 
Check wt daily 
Strict input output charting 
Salt restriction <2g/day 
Fluid restriction<1 litre /day 
Bp, pr 2 nd hourly
Tab dytorplus po bd
Day 3
Rx
Rx-inj lasix 20mg iv stat 
Tab losartan-h (50/12.5) 
Tab carvedilol 3.125mg po od 
Tab ecospirin 150mg po od 
Tab atrovas 40mg po od
Strict input output charting 
Salt restriction <2g/day 
Fluid restriction<1 litre /day 
Bp, pr 2 nd hourly 
Day of dischargeRx-tab lasix 20mg  po od
Tab losartan-h (50/12.5) 
Tab carvedilol 3.125mg po od 
Tab ecospirin 150mg po od 
Tab atrovas 40mg po od
Strict input output charting 
Salt restriction <2g/day 
Fluid restriction<1 litre /day

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