Cardiology postings

 40/F , Housewife , came with chief complaints  of chest  pain since3 days ,acute onset , continuous , gradually progressive ,diffuse all over chest - dragging and burning type of pain , predominantly at right infraclavicular area and reterosternal pain .pain increased on doing daily routine activities like sweeping ,bending forwards , climbing stairs ,Assosciated with palpitations and sweatings. Relieved with rest . Shortness of breath since 3 days - on walking ,doing daily routine activities, gradually progressive , worsened with activities and she is comfortable at rest . No pedal edema ,no abdominal pain . Patient never had similar complaints in the past . Patient gives history of High BP recording and usage of antihypertensives for 1 week prescribed by an RMP and discontinued on his advice .   She has no history of DM ,asthma , epilepsy ,CAD ,CVA  There is no family history of DM ,HTn ,CAD  No addictions  Angio showing RCA , collaterals from RCA t...

 35 year old male patient who is a welder by occupation  Was apparently alright  2 days back then he developed chest pain on 19/1/2021 at 11 am ,chest pain was reterosternal diffuse ,dragging type ,severe assosciated with profuse sweatings , palpitations ,shortness of breath -acute onset,severe and was unable to complete full sentence . No syncope ,no pedal edema ,no wheeze ,no chest tightness. He is chronic alcoholic since 5 years ,consumes daily after work . Non smoker . He visited a local doctor ,got some analgesics .He felt comfortable till 3 am the next day ,when he again developed severe chest pain associated with sob and was sleepless .He couldn't visit any hospital . The next morning patient went to back to the same doctor ,and he was given loading dose and referred here . Patient presented to our casualty with severe chest pain,pain scale 10/10 with sob . Vitals -BP-100/70 mmHg ,PR-70/ min ,RR-21/min  Sats-95%  Ecg - showed ST Elevation in inferior and ...

 36 yr old male patient ,who is a tractor driver, was apparently alright 2 days back ,then  he developed chest pain - sudden onset , gradually progressive  Pain at  reterosternal region , squeezing type type , radiated to left upper limb assosciated with profuse sweatings . He had 1 episode of vomiting and then loss of consciousness for 1 min . No sob , palpitations . He is a smoker since 3 years - smokes 10-12 cigarettes /day  He is occasional alcoholic . He was taken to local hospital in nalgonda next day w,he was given loading doses as ecg revealed St elevations in anterior leads ,echo showed RWMA in apical region  and referred to higher centre . Ecg showing hyperacute Tall T waves With ST elevation in V2-V5 Patient went to another hospital,where Ecg showed AIVR ,TRop I and Trop T were positive. Absent P waves,with broad QRS,St elevations in anterior leads- Idioventricular rhythm. Patient presented to our casualty with severe reterosternal chest pain . S...

 41/F patient came to hospital with  C/o shortness of breath since 12 years  Heaviness in chest since 12 years  Patient was apparently assymptomatic 12 years back then while farming suddenly she developed shortness of breath - sudden in onset , gradually progressive , assosciated with heaviness in chest .no palpitations ,no sweatings ,no pedal edema ,no cough . She then consulted a local doctor and was said to have dust allergy ? . As her symptoms didn't resolved she consulted cardiologist - and was said to have cardiac disease and on medications . Patient experiences sob every 2 monthly ,with heaviness in chest . No pedal edema  Shortness of breath is gradually progressive - initially patient experienced sob on exertion ,now progressed to sob on activities like washing clothes,sweeping floor , on climbing stairs ,1 month back patient developed sob while sleeping that progressed and got hospitalised . Since 10 days patient is having orthopnea ,Sob on sweeping fl...

 70/M patient  presented with complaints of  Shortness of breath since 15-20 days . Gradually progressive  Patient says that he has   disturbed sleep and experiencing severe shortnessof breath at around 5am daily since 20 days ( no leading question was put )  Orthopnea +  Patient has noctuira since 20 days . No seasonal variation of Sob ,no chest pain ,no palpitations ,no chest tightness . no sweating, No pedal edema ,no decreased urine output. No cough, cold ,no wheeze ,no abdominal distension . No Bowel and bladder dysfunction. Patient is chronic alcoholic and smoker since 30-40 years . Patient is non diabetic ,non hypertensive ,no  CAD,CVA. On examination :  No pallor , icterus , cyanosis ,edema or lymphadenopathy , Cvs examination  No jvp ,carotid pulsations present  Inspection -  Apex impulse visible at 6th ics  No parasternal heave ,no visible sinuses ,scars  Palpation - apex impulse -6th ics just lateral t...

 50 year old male patient who is a farmer by occupation presented with complaints of  1- shortness of breath since 4 years  2- palpitations since 4 years . Patient says he had  chest pain 5 years back - diffuse ,squeezing and severe  for 1 day -for which he visited a doctor and was said to have MI ? Patient experienced severe shortness of breath 4 years back -at 12 am  - sudden in onset ,severe and lasted for half hr to one hour  ,he woke up and walked for few minutes and took rest .In the mrng patient went to hospital and was said to have cardiac disease ?  Later on he was put on medications and  was on regular follow up . Shortness of breath gradually progressed over 4 years -  Since 5 months patient is  experiencing shortness of breath - on exertion ( farming ,on lifting heavy weights,walking for long distance ,climbing stairs) . patient work has been gradually declined over 5 months ,as he says he becomes dyspneic on doing heavy...

 35/ M patient who is a tractor driver and a farmer was apparently alright before 27/12/2020  Patient while ploughing experienced severe chest pain - diffuse all around left precordium  Radiating to left shoulder ,squeezing type ,lasted for more than 1-2 hrs . Patient immediately went to a local RMP where his BP was 180/100 and was given antihypertensive ,and pain medication . And he continued working . He experienced similar pain in the evening and went to same local RMP and got some pain relief injection . Patient says his pain relived .and he continued working  On 1/1/2021 - while sparying pesticide, patient developed profuse sweating ,with left side chest pain , radiating to left shoulder and neck . Patient ignored it and took some rest  On 3/1/2021 patient had mild chest discomfort and approached a doctor . Where ecg and echo was done - suggestive of Anterior wall MI - he was given loading dose of aspirin ,clopidogrel ,atorvas ,and heparin stat . Patient ne...

 56 year old female patient  presented to emergency on 5/6/2021 with acute onset of chest pain  Shortness of breath since 2 days. Chest pain - severe, pain scale 10/10 , gradually progressive , diffuse ,over left precordial region and right sternal region . Assosciated with shortness of breath - NYHA grade 4 --- , orthopnea ,PND+, Patient had history of fall due to giddiness  4 days back ,no loc , vomitings,seizures . No pedal edema ,no palpitations ,no sweatings .no wheeze ,no cough ,no decreased urine output . No belchings ,no pain abdomen . No history of similar complaints in the past . Patient is known HTN since 5-6 months and on regular medication . Ecg showing - QS complexes in 2,3,avf  St depression in V1-v4 . Inferio - posterior wall MI ,Trop I - 27858 . Patient was started on Heparin infusion ,nicorandil infusion ,Clopitab ,metxl , atorvastatin . Ecg on 7/1/21 - showed PR prolongation - 0.2 sec .      First degree heart block  Patien...