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Followup To
Question -
I would like to know if an elderly patient that has bronchitis like symptoms and is feeling extremely ill and weak (to the extent that she cannot stand up or walk) is sent by her general practitioner for a chest x-ray to rule out pneumonia and the report comes back with the following interpretation, is this suggestive of possible heart failure? If so, what needs to be done next? INTERPRETATION: "There is marked cardiomegaly; The costophrenic angles are blunted bilaterally; No acute pulmonary infiltrates are noted". Please explain in as much detail as possible what should be done for this patient and what is the next step. Should this patient be hospitalized for observation and testing?
Thanks much for your help.
Answer -
It depends on the patient's clinical status..... this type of patient is hard to figure out sometimes, because it could be heart related, could be lung related or both. A BnP-basic naturetic peptide blood test is a good test, it will be very high if the problem is CHF. Should they be admitted-depends on the situation... if too weak to walk/stand up, then probably yes.
Hope this helps.....
I'm not sure what you mean by patient's clinical status. I can tell you the patient is 79 years old; has difficult to control high blood pressure -160s/80-150s/80 even with meds which are Norvasc, Cozaar, and Lasix. The patient is overweight at 186 pounds. She also has a very loud honking non productive cough and has edema. Any more info with my additional details?
AnswerIt is too hard to try and diagnose over the internet.... It is hard enough when I work in the ER and see someone for the first time. If you are unsure, tell his doctor, or take him to the ER... But at that age with multiple problems, anything can happen....
