Personal data:
Sara Mohammed Ali Alarygy Female patient 12 years old, Right handed , blood group is O+ , Born in Taiz, and live in Amran city.
No Spacial habit for medical important .
Source of information from Patient's Mother.
Date of Admission:in 8 /December/ 2024
- Chief Complaint:
Fatigue and breathlessness for 2 months before addmition.
.
- History of Present Illness:
According to the patient's Mother she was well until two months ago when she started experiencing progressive fatigue, difficulty in breathing during exertion, and mild chest pain. The symptoms gradually worsened, and she now experiences difficulty even during minimal activities like climbing stairs. Occasionally, her mother noticed swelling in her legs and palpitations. There was no history of fever, cough, or significant weight loss .
There is no cough, no wheezing, no striders, no horseness of voice , no hemoptysis, no sputum, no claudication, no dyspnea, no chest pain , no crypetaition, no dyspnea , no epistaxis , no
- Review of Systems:
- General review. Occasional loss of appetite There is no fever or sweating, no weight loss , no
- GIT:** there is no abdominal pain, no Nausea or vomiting, no hematemesis, no melena, no hematochezia , no heart burn no dysphagia, no dyspepsia, no odynophagia , no regurgitation, abdominal distension or Cramps.
- CNS: there is no headache, No syncope, no seizures, or weakness, no blurred vision , no convaletion, no trouble of the speech, no loss of movement.
- Urinary: there is no lion pain , No urgency, no frequency , No dysuria, no pyuria or hematuria , no histansy no pain during micurination , no polyuria no oliguria, no anuria .
- Past History:
Diagnosed with acute rheumatic fever at age 9, treated with antibiotics, but no follow-up prophylaxis.
No History of chronic disease.
No blood transfusion.
No allergic .
No Surgical history.
- Family History:
No similar illnesses. Parents and siblings are healthy.
No History of the chronic disease.
- Socioeconomic History:
Family lives in crowded conditions, poor sanitation, limited access to clean water.
No travel history.
- General Examination:
Conscious, cooperative, mild pallor. Pitting edema in lower limbs. No cyanosis or jaundice.
- Vital Signs:
HR: 112 bpm, BP: 90/60 mmHg, RR: 24/min, Temperature: Normal.
- Systemic Examination:
- CVS: Apex beat displaced, systolic murmur heard at the mitral area.
- Respiratory:Normal breath sounds with mild basal crepitations.
- Abdomen:Soft, no organomegaly.
- CNS: Normal reflexes, no deficits.
What is the best differential diagnosis for this cases?
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