A 70 years old female referred from surgery to GM with the shortness of breath and b/l pedal edema


Patient was apparently asymptomatic 2weeks back then she developed right leg swelling associated with wound on  the right ankle and right leg anterior region. Swelling extended from the right foot to the mid part of shin.debridement of infection was done four days back.she had h/o of atrial fibrillation before surgery which is controlled. After surgery due to stress  induced  factor atrial fibrillation which-eventually  lead to left heart failure and then right heart failure she developed shortness of breath and pedal edema.
No h/o of fever, vomiting
Past history:
Not known Case of HTN,DM, asthma, qq1
Personal h/o
Diet: mixed
Bowel and bladder! Regular.
Family ho:- No significant family history.
GENERAL EXAMINATION:
  pt is cc and non cooperative, moderately built and moderately nourished, well oriented with place and time,
No pallor, no icterus, no cyanosis, no clubbing, no lymphadenopathy.
Vitals:
Pulse rate- 123
Bp - 110/80
Rr- 22
Temp- 98.4F
Oxygen saturation 96%
Systemic examination:
CVS: no thrills ,cardiac sounds S1,S2,S3 heard.
Respiratory system :normal vesicle breath sounds and position of the trachea central .
Abdominal examination: no soft organomegaly
CNS: NFND

https://youtu.be/fVfk6iRn6Ss
https://youtu.be/D9XB4Fc3t48
Diagnosis:Heart failure.

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