The patient has also been previously treated for episodes of pneumonia, One day prior to admission patient called in requesting antibiotic because of developing green sputum. However, he developed progressive dyspnea and anterior chest pain. When he arrived, he was in severe respiratory distress . A chest X-ray showed mild CHF, cardiomegaly and pulmonary congestion. There is no definite neck vein distension, no adenopathy.
Lungs reveal prominent coarse rales, both lungs posteriorly.
No murmur The pericardium is dynamic. 2-Probable CHF, rule out underlying pneumonia or pulmonary infarctions. 5-Chronic nephrotic syndrome. 6-Chronic iron overload syndrome with hemosiderosis of the liver from previous transfusions. 7-Chronic narcotic dependency.