30 yrs male....h.o... palpitations....chest discomfort....since last 2 month....lot of hyperacidity....h.r...100 to 120 min... always.... anxiety....fear...sudden anything happened......so all test done...normal...work as pharmacists..... ecg also....done....so pls suggest how to manage this case....also...palpitation and heart rate..@@Dr. Shivraj Agarwal

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Refer to the Psychiatrist for proper history taking & MSE, to arrive at an appropriate Psychiatric Diagnosis. He is suffering with Anxiety Spectrum Disorders, but full history would be needed, for a specific diagnosis.

ECG is normal except for sinus tachycardia. Hyperthyroidism should be ruled out . Most likely Generalised Anxiety Neurosis .. Acid Peptic Disease or GERD Propranolol 10 mg BD can control heart rate. Suggest psychiatric consultation

Sinus tachycardia Rbbb GERD 2decho endoscopy Gastritis with anxiety neurosis

Not RB3 ONLY R wave in v1
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Sinus tachycardia H/o anxiety Yes pt seems to be psychotic Needs psychiatrist and psychotherapist

S.Tachy Check for thyroid, HB level Generalised Anxiety disorder

Sinus tachycardia RBBB Cap Pantop 40 BD Itopride BD Ambulax M in morning Clonzapam 0.5 hs

Not RB3 ONLY R wave in v1
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Tab inderal 40mg Half bd Tab escitalopram 10mg morning Tab lexotanil 3mg hs Ecg looks normal except LVH. 2 D ECHO