202113662
Case History and Clinical Findings: 69 year old male chronic smoker since 40years and alcoholic since 20 years known case of hypertension sine 5 years was apparently asymptomatic 5 years back until he had sudden onset chest pain and SOB for which he was taken to a hospital in hyderabad where he was told to be having some heart problem and symptomatic treatment was given (no records are available). patient was completely asymptomatic from then in the past 5 years until last night when he had low grade fever and 2 episodes of vomiting after alcohol intake. From 16/6/21 morning he had pain abdomen,abdominal distention ,SOB and drowsiness. Patient came to the casuality in a state of drowsiness with pain abdomen ,distension ,SOB and generalised weakness. O\E: Pt drowsy but arousable , coherent and cooperative JVP raised PR: 78bpm BP:110/70 mm hg SpO2:98% on RA CVS: s1,s2heard RS:BAE + , NVBS , Fine crepts + in Right IAA & ISA P/A: soft,dist...