An interesting case of cor pulmonale

A 14 yrs old boy presented with a history of breathlessness since 1 yr which had increased from 2 days, cough with expectoration and pedal edema since 7 days. In the past patient had history of kyphoscoliosis since birth and had a history of repeated URTI. On examination he had tachycardia, tachypnea, raised JVP, kyphoscoliosis, bilateral pitting edema. Respiratory auscultation revealed bilateral fine crepitations and wheezes. On investigation haemoglobin: 14.6, T.L.C: 20,000,chest X-ray: kyphoscoliosis with cardiomegaly. Clinical diagnosis of corpulmonale due to kyphoscoliosis was achieved and was confirmed with 2D echo. ECG showed RVH. The patient was treated with oxygen, diuretics, antibiotics, bronchodilators. Patient improved and was discharged on bronchodilators and was asymptomatic on follow up.