65F Heart failure with preserved ejection fraction , ITP
A 65 years old female came to opd with c/o breathlessness since one week, insidious onset gradually progressive, grade 2-3 nyha, aggrevated on exertion, relieved with rest HOPI: Patient was apparently asymptomatic 10 days back then developed shortness of breath. H/o generalized weakness and easy fatiguability No h/o chest pain, palpitations, syncope, orthopnea, pnd No h/o cough, cold, fever, abdominal distension, facial puffiness, pedal edema, decreased urine output Past history: h/o similar complaints in 2010, got 3prbc transfusions for Anemia, normal bone marrow biopsy, negative direct indirect coombs, in 2011 treated with steroids K/C/O: 2mnths back got dental procedure done, associated with blood loss, and started on steroids N/K/C/O : DM/ HTN /CAD / CVA / ASTHMA / THYROID /SEIZURE DISORDERS Personal history : _ occupation : homemaker Patient is married Patient takes mixed diet appetite is lost Bowel and bladder movements are regular Micturition is normal No known allergies