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
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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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