Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, non-productive cough, and orthopnea in the setting of known decompensated cirrhosis. Symptoms exacerbated by exertion and recumbency. No fever, chest pain, or hemoptysis reported. History of ascites noted.
Clinical Examination Findings
Respiratory: Decreased breath sounds at the [Right/Left] base, dullness to percussion, and reduced tactile fremitus consistent with pleural effusion. Cardiovascular: Tachycardia, S1/S2 normal, no murmurs. Abdomen: Distended with positive fluid wave/shifting dullness (ascites). Extremities: 2+ pitting edema noted bilaterally.
Treatment Protocol
1. Sodium restriction (<2g/day) and diuretic therapy (Spironolactone/Furosemide). 2. Consider therapeutic thoracentesis for symptomatic relief. 3. Evaluate for TIPS (Transjugular Intrahepatic Portosystemic Shunt) if refractory. 4. Monitor electrolytes and renal function closely.