IHD WITH UNSTABLE ANGINA - PowerPoint Presentation

Slide1

IHD WITH UNSTABLE ANGINA

12Q1326

SCENARIO:

Here is the male patient of age 60 yrs was admitted to

the

hospital with complaints of chest pain since morning 10am radiating to arm and back pricking type and sweating and nausea

.

CHIEF COMPLAINTS:

c/o chest pain since 10am radiating to arm and

back,pricking

type

sweating since 10am

HISTORY OF PRESENT

ILLNESS:

Patient

was apparently alright upto 10am then he developed chest pain at L-mammary which is acute in onset and progressive in nature radiating to arm and

back,pricking

type.lasted

for 5

minutes.sweating

vigorously since 10am then he lasted for 15-20

min.nausea

since 10am acute in onset and progressive in nature.

PAST MEDICAL HISTORY:

Nothing significant

PAST MEDICATION HISTORY:

Nothing significant

FAMILY HISTORY:

Nothing significant

PERSONAL HISTORY:

Nothing significant

SURGICAL HISTORY:

Nothing significant

LABORATORY INVESTIGATIONS:

(why test performed):

CBC count: it is a blood test used to evaluate overall health and detect wide range of disorders<including anemia,infection,leukemia.ESR:it is useful for detecting inflammation in the body that may be caused by infection.use for diagnosing some cancers and certain autoimmune diseases.

sno

Reference Values

Test Values

Result

1

Polymorphs(40-60)

83

Increased

2

Lymphocytes(20-60)

16

Decreased

3

MCV(80-100)fl

105.7

Increased

4

MCH(32-36)g/dl

38.1

Increased

CPK

MB:

this

test is perfored to detect heart disease like IHD.this test is done after patient experiencing symptoms of heart diseases.this testvmeasures the level of creatine phosphokinase in the blood and used to detect muscle damage.LIPID PROFILE TEST:this

test is used to identify

hyperlipidemia of cholesterol and tryglycerides levels which are use for recognising cvs diseases.

snoReference ValuesTest ValuesResult1ESR(mm/hr)M<10,F<2020Increased

sno

Reference Values

Test Values

Result

1

CPK MB(0-26)u/l

15

normal

ECG:

this

is performed to measure the electrical activity of our

heart.heart generates electrical signal which flows from heart to whole body.it can determine whether the heart is performing normally or suffering from abnormalities.

sno

Reference ValuesTest ValuesResult

1Cholesterol(150-250)mg/dl313Increased2VLDL(15-45)mg/dl98Increased3Triglycerides(65-170)mg/dl249Increased

4

LDL(90-136)mg/dl

192

Increased

SUBJECTIVE EVIDENCE:

complaints of chest pain radiating to arms and

back,sweating

since 10am.and nause since 10am.OBJECTIVE EVIDENCE:X-rayDIAGNOSIS:based on laboratory investigations and subjective,objective evidence the patient diagnosed with IHD-UNSTABLE ANGINA.

MEDICATION CHART:

sno

Trade

NameGeneric NameDose

Indication

123

45671I.Kephazone 1-0-1cefoperazone1gmantibioticyy

y

y

N

N

N

2

I.Pantodoc

1-0-0

pantoprazole

40mg

PPI

y

y

y

y

y

N

N

3

I.Vomikind

1-1-1

ondansetron

1amp

Anti

emetic

y

y

y

y

y

y

y

4

T.Sorbitrate

(1-1-1)

Isosorbide

di

nitrate

5mg

angina

y

y

y

y

y

y

y

5

T.Clopivast

(0-1-0)

clopidogrel

150mg

Anti platelet

y

y

y

y

y

y

Y

6

T.Tonact(0-0-1_

atorvastatin

40mg

hyperlipidemia

y

y

y

y

y

y

y

sno

Trade Name

Generic Name

DoseIndication12

3

456

77I.Hepanox 1-0-1enoxaparin0.4mlthrombosisyNNNN

N

N

8

T.Anxit

0-0-1

Alprazolam

0.25mg

Anxiety

y

y

y

y

y

y

Y

9

SYP.cremaffin

plus

Liquid paraffin

2 tsp

laxative

y

y

y

y

y

y

Y

10

I.Hapanox

1-0-1

enoxaparin

0.4ml

thrombosis

N

N

y

y

y

N

N

11

I.Ceftriaxone

1-0-1

ceftriaxone

1gm

antibiotic

N

N

N

N

y

y

y

12

Cap.neopride

1-0-0

levosulpride

psychoses

N

N

N

N

N

N

y

ASSESSMENT OF EACH TEST:

ESR:

ESR increased due to infection that associated with heart disease like IHD and

angina.it is increased during inflammation.POLYMORPHS:polymorphs are increased due to infection or inflammation.the role of polymorphs is to defend the body from microorganisms and substances which harm the body.when there is inflammation in the body the production may increases.LYMPHOCYTES: Lymphocytes play an important role in the immunologic activity and produce antibodies.decreased lymphocytes causes decrease in immunity which leads to severe illness.

PHARMACEUTICAL CARE ISSUES:

No issues are found

MONITORING PARAMETERS:

Continuous ST-segment monitoring in unstable angina.Oxygen supplement.Monitoring cholesterol levels.Reduce or prevent angina symptoms.CONCLUSION:Based on laboratory interpretation the patient is diagnosed with IHD with UNSTABLE ANGINA.