42M with sudden SOB and pedal edema.

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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' 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.



Patient brought to casuality with complaints of SOB at rest and pedal edema. 


Bp at the time of admission 230/100mmhg
Pr 110 bpm
RR 34 cpm
Spo2 - 55% on RA.

Patient was given inj. NTG and Diuretics. 
Post NTG BP 170/90.

ABG : metabolic acidosis 

Post CPR ecg

Inspite of high flow oxygen patient spo2 is 65%. Patient is planned for intubation.
Pre intubation patient suddenly became unresponsive with no central pulses. Immediate CPR was done and Patient revived.

Post CPR & intubation

Patient was sedated and paralysed over night in ACMV-VC mode with peep 6-7 fio2 40%, Vt 450ml.

Day 1 : 
S - patient is off sedation & paralysis and moving all 4 Limbs and responding to commands (1 step )

O - bp 140/90 
Pr 82 cpm
RR 22 cpm
Spo2 97%
Cvs S1 S2 heard
RS - BAE PRESENT
E4VtM6
Trop i = 346 to #20230


A - acute cardiogenic pulmonary edema 2to ?NSTEMI with ? Aspiration pneumonia

P - plan to extubate if criteria meets.

Patient extubated successfully as he met extubation criteria.




Patient was observed for 2 days. As he is hemodynamically stable and angina resolved and was sent to cardiologist for opinion.



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