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you thank you very much for inviting me so we are moving away from electrical problems to structural problems my topic is heart failure Ill start with the case I saw a few weeks ago he is a 57 year old man presented with effort breathlessness for six weeks with bilateral leg swelling and the only previous history was he is a hypotensive for the last four years and hes a nonsmoker with moderate alcohol intake on examination there were no cyanosis anemia go clubbing and bilateral painless pitting edema pulse was 110 and regular blood pressure 145 over 96 raised jvp about three centimeter normal heart zones increase respiratory rate scattered wheeze but no crackles write up a corneal turn on us with hepatomegaly so what is the cause of breathlessness this is a question so you can answer now so is it left heart failure later onset bronchial asthma chest infection right heart failure or congestive heart failure right okay so youll know so well go on to the heart failure proper the defin
