In the photo is Mr. R., 80 years old, who came in with difficulty of breathing. At first look you will think that he is suffering from asthma. Even the patient and his children thought so. But with proper history and physical examination, we found out that he is suffering from heart failure.
The patient was found out to have irregular heart beat four years ago. He was hypertensive since then, was given maintenance medications but was lost to follow up. Now he is having easy fatiguability and inability to lie down from sitting position. Lying down will make him dyspneic again.
What caused his heart to fail? His high blood pressure gradually exhausted his heart's strength causing it to become weak thus affecting its function. Normally, the heart should be able to pump efficiently. If not this will cause blood to back up into the circulatory system. This will then lead to more problems like swelling of the abdomen and edema in the legs, ankles, and feet.
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