35 M Headche ,vertigo,vomiting,sweating,Bp 140 90 P 67 Temp 98 Spo2 98 ecg enclose DD and Treatment

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This looks to be c/o of VERTGO ( Bpvv) Symptoms of headache vomiting and giddiness are suggesting bpvv . Ecg looks to be normal with sinus rythm and normal HR. His bp as you mentioned is 140/90 this range is not alarming or worrisome. I will suggest to treat him as vertigo/ bpvv Rx tab betahistamine(verbet or vertin) 16mg 1tds for 5 days once giddiness is controlled than rduced to bd or od dose for 1month. Also add tab stemetil md 5mg 1tds for 3to 5 days. For headache give hifenac p 1tds till problem is there.. beside this you should see his profession position of neck or stiffness and examine ear as well.to r/o meniers also assess by history to r/o migraine.i don't see any cardiac cause.

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ECG RBBB.So associated problem actively not related c heart disease.DD 1 Cluster headache 2 V V attack 3 Vascular headache 4 Hypoglycemia 5 Gastric Upset 6 Carotid or Vertebral vessels occlusion 7 Post ictial headache 8 Unstable angina (ECG may show normal)

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Sinus arrhythmia, 67 bpm, Axis normal, RWP good, RBBB, 1st degree AV block, ST elevation elevation in 2 to V6 and aVL. No reciprocal ST depression Inferior leads. Do Trop-T and 2D Echocardiography, X-ray CS AP and lateral view, CT scan brain, CBC, RBS, RFT, Serum Electrolytes, Lipid profile, Urine for RE and ME etc

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BP 140/90 KIND OF HYPERTENSION HEADACHE COULD BE DUE NTO HYPERTENSION VERTIGO VOMMITING DUE TO E N T CAUSE VESTEBULITIS ADVISED E N T EXAMINATIIN AUDIOMETRY

To classify vertigo More details of episode are required With examinations of CNS Can u please?

NOT A RBBB Because lack of S wave in v1 & negligible s wave in V6 This pattern appears because v1 v2 placed too high in chest Repeat ecg may be normal Non significant ecg

ECG ..IS NORMAL ...MILD HTN , NEED RX POSSIBLY VERTIGENOUS MIGRANE

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ECG. Lat. Wall ischemia. Acute Pericarditis.

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Rbbb

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ECG findings are innocent bystanders here Rbbb

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