37 year old Chronic alcholic with SOB and Anasarca

N.Sneha

Roll. 92

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A 37 year old male came to the casualty with the chief complaints of

•shortness of breath since 6 days.

•generalised swelling of the body.

•Decreased urine output.

History of present illness

The patient was apparently asymptomatic 12 years back then he developed generalized swelling all over the body which was insidious in onset and gradually progressed up to 3 months and then he came to our hospital and he was referred to the higher Centre afterwards. When he was in our hospital ,when the BP was checked there was so much variation found between the two arms. In the higher Centre ,he was treated for about a 4 to 5 days and then he became normal and got discharged . For 3 months he didn't take any alcohol or any smoking but after 3 months he again started drinking alcohol and smoking.

Afterwards he had on and off episodes of edema,so he was took a tablet of lasilactone and the edema subsided after taking the tablet. 2 months back he developed edema which did not subside on medication, so he came to our hospital and was given lasix. 5 to 6 days back,he again started developing edema which didn't subside even after taking a higher dose of the tablet and he developed a shortness of breath from the past 4 days. He is not taking enough meals because he is having that SOB and distension of abdomen while sitting and eating. He had a good appetite but he was not able to eat. On September 14th around morning from 1:00 a.m. he had shortness of breath and around 3:00 a.m. he was not able to take breath and came to our hospital

H/o dark colored stool since 4 day

H/o decreased urine output since 3 days

H/o dry cough ( sometimes only )

No h/o of fever

He is a chronic alcoholic since 2002

He takes alcohol almost daily about a 15 units.

Last consumption of alcohol was 20 days back.

A chronic smoker takes 1 - 2 packs per day

Past history:

Not a known case of DM/HTNTB/Asthma/Epilepsy/CAD/CVA/Thyroid disorders.

Personal history

Diet -mixed