Triple vessel disease with acute onset chest pain in young female with mild changes on ecg

 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 to LAD












Plan : CORONARY ARTERY BYPASS GRAFTING




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