Unstable Angina By SMahalakshmi SENARIO Here is a 55yrs old female hospitalized for 5 days CHIEF COMPLAINTS Chest discomfort since 1 hour HISTORY OF PRESENT ILLNESS Patient was apparently well 1hour back ID: 934364
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Slide1
Therapeutics-1 minor case presentationUnstable Angina
By
S.Mahalakshmi
Slide2SENARIO:
Here is a 55yrs old female hospitalized for 5 days.
CHIEF COMPLAINTS:
Chest discomfort since 1 hour.
HISTORY OF PRESENT ILLNESS
:
Patient was apparently well 1hour back
following which she developed chest discomfort,
squeezing type,
retrosternal
region radiating to left
shoulder
aggrevated
on exertion associated with
excessive sweating.
Slide3PAST MEDICAL HISTORY: History of trauma to left hand 1month back patient is on physiotherapy.
LABORATORY INVESTIGATIONS:
Date
6/77/78/79/710/7Hb10.8PCV32.3MCH25.8CKMB31.0
Blood
pressure
130/70
104/60
100/70
110/70
110/70
Pulse
rate
90
84
84
84
84
Slide4SOAP NOTE:Subjective: Here is a 55yrs old female patient
presenting with complaints of chest discomfort
since 1 hour.
Objective:
Hb-10.8 decreased due to anemia.PCV-32.3 decreased due to hypervolemia.MCH-25.8 decreased due to hypochromia.Echocardiography:IHDRegional wall motion abnormality present.Impaired resting LV systolic function with LVEF of 35%Grade1+ mitral regurgitationNormal PA pressure
Slide5Diagnosis: Unstable Angina Problem lists:
chest pain
: due to lack of oxygen or decreased blood supply to myocardium due to coronary artery narrowing or obstruction lead to chest pain.
Unstable Angina: decrease in oxygen supply to the heart due to formation of atherosclerotic plaques.Anemia: decreased haemoglobin due to iron deficiency
Slide6s.n
Problem list
standard treatment
1.
Unstable anginaa.Beta blockers: it decreases the heart rate ,contractility,and blood pressure there by it reduces oxygen demand in patients. b.Aspirin: it reduces the pain caused due to lack of oxygen supply.c.Statins: it reduces the cholesterol synthesis there by increases the blood flow to the cardiac musclesd.ACE inhibitors: it acts by inhibiting the conversion of AT1 toAT2 ,there by reduces BP.
Slide7Trade name
Generic name
Dose
6/7
7/78/79/710/71.Inj.pantocidpantoprazole40mg1-0-0 YY2.t. IsodrilIsosorbide dinitrate5mgStatY
3.
t.sorbitrate
Sorbitrate
10mg
1-1-1
Y
Y
Y
4.
t.clopivas
clopidogrel
75mg stat
Y
5.
t.ecospirin
aspirin
150mg
0-0-1
Y
Y
Y
cap
0-0-1
6.
t.tonact
atorvastatin
40mg
Stat
Y
7.
Inj.hepanox
enoxaparin
0.6ml
1-0-1
Y
Y
Y
Y
Y
8.
Cap.ramace
ramipril
2.5mg
1-0-0
Y
Y
Y
Y
Y
9.
Syr.cremaffin
plus
Liquid paraffin
3tsp
0-0-1
Y
Y
Y
10.
t.anxit
alprazolam
0.5mg
0-0-1
Y
Y
Y
Y
11.
t.dolo
paracetamol
650mg 1-0-1
Y
Y
12.
t.rabo
rabeprazole
20mg
1-0-0
Y
Y
Y
13.
t.nitrocontin
Glyceryl
trinitrate
2.6mg1-0-0
Y
Y
Y
Slide8NO DRUG INTERACTIONS DISCHARGE DRUGS
C
ap.Ramace : 2.5mg 0-0-1 15 days
T.Anxit :0.5mg 0-0-1 15 days Cap.Ecospirin gold : 150mg 0-0-1 15 days T.Nitroconitin : 2.5mg 1-0-0 15 daysPrognosis : condition improvedDRPSINDICATION WITH OUT DRUG no drugs were given for anemia
Slide9THANK YOU