AF with FVR and severe MS
A 55 year old female ,who is an agricultural labourer came to the casualty around 7pm with the complaints of shortness of breath since 10 days , increassed from doing minimal works to at rest since 2 days C/ O palpitations since 10 days C/ O decreased urine output since 3 days Anasarca since 3 days Nausea and vomiting since 10 days HOPI: Pt was apparently asymptomatic 10 days ,when the patient had fever for 5-6 days,not associated with cough, cold,loose stools, decreased on medication with paracetamol,after which the patient had shortness of breath even at rest for which she stopped going to the fields,this was associated with palpitations,feeling of nausea and 1 episode of vomiting and light headedness, then she had a decrease in urine output since 3 days , did not pass stools , abdominal distension,pedal edema , for which she was brought to the hospital. Past history: Not a k/c/o diabetes, hypertension,ckd ,cad. Similar complaints of SOB and palpitations 5 years back ,when she wa