Name :PUJAPPA Age :14yrs Sex :Male Address:Marenali Bagnur post ,yelanka ,Bangalore North. Informant :Father ,Mother & self(reliable) DOA:17-03-05. No h/o cough, fever, chest indrawing No h/o palpitation,edema of feet,decrease urine output.
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Bagnur post ,yelanka ,Bangalore North.
weakness of limbs.
No h/o suggestive of ALRI
No h/o admission to hospital
1—no h/o drug intake,fever with rash
2--- no h/o suggestive PIH,DM
home delivery conducted by untrained dai.
BCIAB avg wt baby.prelacteal feeds sugar water 2-3spoons .started breast feeding 2hr after birth till 5months.
No h/o intermittent feeds
No h/o sweating over forehead during feeding
1room 1kitchen kerosene stove cooking
out door sanitation.
low socioeconomic status
h/o breathlessness on exertion with squatting episodes since age of 3yrs.
h/o not gaining wt.
no h/o repeated ALRI/CCF
peripheral pulses well felt,no R-R,no
medial to MCL.
No precordial bulge
No other visible pulsations.
0.5cm medial to MCL,Normal.
Thrill left 2,3,4 ICS along sternal border.
Parasternal heave grade 1
no epigastric pulsation,
no palpable P2
Percusion :left border corresponds to apex.
ejection systolic murmur of grade 4 heard best in left upper sternal border with diaphragm ,during inspiration,with sitting posture.
MA:S1S2+ same ejection systolic murmur +
PA : S1S2+, single S2,well heard , same ejection systolic murmur .
B/L symmetrical chest movement+
B/L air entry
no organomegaly ,BS+
with no evidence of IE.
DORV with PS
TGV with VSD with PS
PR interval 0.16sec
QT interval 0.32 sec
Right axis deviation (+120)
RVH –Tall R wave in V1 &deep S wave in V6