47 yrs MALE PATIENT WITH VIRAL PYREXIA, WITH HEART FAILURE WITH MIDRANGE EJECTION FRACTION, CAD, WITH ARRHYTHMIAS

47 yrs Male Patient came with complaints of FEVER since 3days
COUGH, COLD since 3days
LOOSE WATARY STOOLS since 3days

HOPI : Patient was apparently alright before 3days, then he suddenly devoloped highgrade fever associated with chills and rigors, fever was Contnuous and Subcided by taking medication. 
COUGH since 3 days associated with sputum which is yellow in colour , non blood stained, mucoid in consistency 
LOOSE STOOLS since 3 dys yellowish to reddish in colour at frequency of 4-5stools per day. 

PAST HISTORY : know DIABETIC on Tab. Metformin 500mg since 4yrs.
K/c/o. CAD underwent PCI 16 months ago on Tab. Dytor 10mg OD, Tab. Ecosprin gold 10mg OD, Tab. Eplerenon OD, Tab. Telma 40 OD, Tab. Trimetazine 35mg OD

PERSONAL HISTORY : Chronic Smoker smokes 2packs per day since 20 yrs , Stopped 16months back
Alcoholic -Regularly takes since 20 yrs, stopped 16 months back
Driver by Occupation

DIAGNOSIS : VIRAL PYREXIA  , HEART FAILURE WITH MIDRANGE EJECTION FRACTION (45%), 2nd ry to CAD S/P (sep 2022) PTCA, TYPE 2 DIABETES MELLITUS (since 4yrs) 
VITALS :
Temp - febrile
PR - 80/min
BP - 100/60mm of hg
CVS - s1, s2 + , no murmurs
RS- BAE + , NVBS +
PA - soft, non tender

TREATMENT : 
Tab. P 650mg BD
Tab. Ecosprin gold 75/20mg OD
Tab. Dytor 10mg OD
Tab. Telma40 + Metoprolol 50mg OD
Tab. Trimetazidine MR 35mg BD
Tab. Eplirenone 25 mg OD
Tab. Metformin 500mg OD








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