56 year old woman with chest pain since 2020 january presented with pericardial effsuion secondary to multiple myeloma
56 year old female kTobacco leaf seller by occupation came to opd in january 2021 with chief complaints of chest pain since 6 months , pricking type, subsiding on its own, no radiation Shortness of breath grade 2(MMRC) since 1 month progressed to grade 4 since 1 day H/o orthopnoea and Paroxysmal dyspnoea and palpitations present No history of cough , wheeze Decreased appetite since 20 days, generalised weakness since 15 days , Pain abdomen since 10 days. Diffuse predominantly in the epigastric region, non radiating B/L Lower limb ,upper limb edema and facial puffiness since 5 days. Edema initially started in the lower limbs then prgressed to upper limbs and then face Palpitations + Syncopal attacks - She is not a K/C/O DM - II , HTN , Thyroid abnormalities and any other comorbidites She is an occasional alcoholic ( beer / whiskey) since 35 years. Chews tobacco leaves daily since 6 months. O/E: Patient is C/C Pallor + No icterus, clubbing , cyanosis, lymphadenopathy pedal ede