Brief Answer:
Please follow as already advised...

Detailed Answer:
Hello XXXXXXX I've gone through your query in details,

I've reviewed all the attached reports here,

See, first of all, the September episode was primarily due to the H1N1 infection as it seems. Which, after the treatment got better subsequently. However, this time's shortness of breath needs further evaluation again as it can be due several other reasons (originating from cardiac as well as pulmonary).

It's good that fever's not reported this time. However, keeping in mind the past history of infection, further assessment needs to be done to find out the possible causes(fever may or may not be there).

I can see they've advised her admission today again, which I do agree as she may need further work-ups as well as strict medical supervision and nursing care for prompt recovery.

Apart from the ECG (it's inconclusive), a repeat Echocardiography is also needed to assess the present cardiac function (which was also rightly advised). Along with this few basic investigations like CBC, Liver, and Kidney function test, a fresh Chest X-ray should be done to look into it further. It's good that they're also looking for other sources of infections which is why those series of sputum investigations were advised.

I believe she's already on Oxygen therapy at home along with nebulization and all the medications which were advised there. So, despite this, if the breathing difficulty is still persisting, I'd suggest you admit her for a quick evaluation and to initiate further treatments under proper medical supervision.

I've tried to explain this in a simpler fashion for you to understand, please let me know if there are any further queries.

Take Care
Kind Regards

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