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. 

Case presentation:


 A 45 yr female daily wage labourer came with c/o Shortness of breath since 3 days


Hopi:
Patient was apparently asymptomatic 3 months back
Then she developed Shortness of breath which is aggravated on exertion and relieved on rest
Facial puffiness and pedal edema since 3 months grade 2 putting type
Abdominal distension on & off since 3 months
At the time of presentation SPO2 without oxygen is 75%.
H/o palpitations present
No h/o chest pain,syncopal attack,loss of consciousness
Noh/o burning micturition, abdominal pain,constipation, diarrhoea.
Noh/o nausea, vomitings.
No h/o orthopnea,pnd
Not a k/c/o DM,HTN,epilepsy, tb,asthma.
Patient is conscious,coherent, cooperative.
Vitals:
AFebrile
Pulse rate 108bpm
Respiratory rate 21cpm
BP 150/90mm hg
Sp02 75% at room air
98% with 6 litres of oxygen
Grbs 137 mg%
Pallor present
No icterus clubbing,cyanosis,lymphadenopathy,
Edema of feet present 
Investigations



Treatment
Salt restriction <1.5gm/day
Fluid restriction <1.5l/ day
Inj LASIX 40mg IV OD



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