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76 years old MALE WITH CARDIOGENIC SHOCK, ATRIAL FIBRILLATION, HFREF (17%) PRE RENAL AKI ON CKD, RIGHR UPPER LOAB FIBROSIS (post TB sequelae)

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76 years old MALE patient came with complaints of DIFFICULTY IN BREATHING since 1 month HOPI :  Patient was apparently alright before 1 month then he devoloped DIFFICULTY IN BREATHING insidious in onset and gradually progressive from grade -1 to grade -2 then to grade -4 (mmrc)  No h/o cough No h/o chest pain, chest tightness  No h/o sweating / giddiness No h/o vomitings /diarrhoea No h/o bleeding manifestations PAST HISTORY : K/C/O PULMONARY TUBERCULOSIS took medication for 6 months 2years ago and also took the same medication for 6 months 4 years ago. Not a K/C/O HTN /DM / ASTHAMA /EPILEPSY/CAD PERSONAL HISTORY : Diet - mixed,  Appetite -decreased Bladder - Normal Bowel - constipation ADDICTIONS : Regular Alcoholic took 1 bottle of toddy/day since 40years , stopped 2 months ago Smokes 4-6 chuttas /day since 40 years, stopped 2  months ago.  FAMILY HISTORY : No history of similar complaints in the family.  No history of DM/HTN/TB/ASTHAMA/EPILEPSY/CAD ...
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DR VENKANNA'S THESIS

TITLE CLINICAL PROFILE, COMORBIDITIES AND OUTCOMES IN PATIENT WITH CARDIAC ARRHYTHMIAS PROBLEM STATEMENT : Arrhythmias are a common dilemma confront- ing the intensivist. They represent a major source of morbidity, and they lengthen hospital stay. Arrhythmias are most likely to occur in patients with structural heart disease. The inciting factor for an arrhythmia in a given patient may be an insult such as hypoxia, infection, cardiac ischemia, catecholamine excess (endogenous or exogenous), or an electrolyte abnormality. Management includes correction of these imbalances as well as medical therapy directed at the arrhythmia itself. The physiological impact of arrhythmias depends on ventricular response rate and duration as well as on the underlying cardiac function. Bradyarrhythmias may decrease cardiac output due to heart rate alone in patients with relatively fixed stroke volumes, and loss of an atrial kick may cause a dramatic increase in pulmonary pressures in patients with diastol...
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84 MALE , COMMUNITY ACQUIRED PNEUMONIA , TYPE- ll RESPIRATORY FAILURE, PARAXYSMAL AF WITH FVR , HFMEF (EF-45,%) , K/C/O.BRONCHIAL ASTHAMA

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PRESENTING COMPLAINTS: 84 YEARS MALE PATIENT C/O.SHORTNESS OF BREATH SINCE MORNING  FEVER SINCE 5 DAYS.  HISTORY OF PRESENTING COMPLAINTS : The patient was apparently asymptomatic before  3yrs gradually he had shortness of breath on and off, which is of GRADE -ll NYHA and sinc morning he had sudden onset of severe shortness of breath associated with minimal exertion.  fever since  5 days associated with chills and rigor intermittent and High grade .   Cough with sputum since 5days whitish in colour, copious in amount. PAST HISTORY: NO H/O. HYPERTENSION  NO H/O. DIABETES MELLITUS  NO H/O. CAD /CVA  NO H/O. TB/ ASTHMA / EPILEPSY  TREATMENT HISTORY: NO PREVIOUS HISTORY OF MEDICATIONS  PERSONAL HISTORY:  Diet - mixed  Appetite - normal  Bladder and Bowel - Regular  Sleep - adequate  Alcohol - Regular 90ml/day since 20yrs Smokes 1pack/day since 20yrs  No drug addictions  FAM...
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