Epigastric Pain & Palpitation s

38 Years old Female presented with chief complain of Epigastric pain & Palpitation from last 6 hours. She denies history of Chest pain/Dizziness/Dyspnoea. Past Medical History. Except Dyspepsia No Known medical illness in past. On Examination. She is anxious PR- 134 /min regular BP. 156/90 mmHg. P/A tenderness on deep palpation in Epigastric region. Pain partially relieved with Injectable PPI & Antacid. ECG attached. Kindly give your valuable inputs. Further Investigations & Management.

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Prominent p mitrale bifid suggestive of atrial hypertrophy or dialated lt atrium NSR Paroxymal ventricular tachycardia Past h/o dysponea is significant We need to subject 2decho and other relevent lab investigations xray chest Rx antiarrythmics Ecosprin or anticoagulants Tranquillisers 02 supplementation if pt is hypoxic or dysponic Rest of supportive treatment

Thanx dr Anil Gangani
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Sinus tachycardia. This epigastric pain can be the cause of her distress. Adv: treat her dyspepsia with PPI. I would suggest endoscopy in this patient to look for H pylori infection or urea breath test, for her unexplained dyspepsia. If found positive it should be treated.

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There is sinus tachycardia There is one additional important finding Lead II shows tall peaked P wave It is a characteristic of P pulmonale, which suggest that there is right ventricular hypertrophy Adv 2 D Echo

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Ask for history of any stressful situation she came across. Appears to be anxiety. Do cardiac markers

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USG Whole abdomen , LFT and CBC Endoscopy Rule GB stone , Pancreatitis,Peptic ulcer syndrome Ad , Pantaprazole OD empty stomach Drotin DS SOS Tab Clonazepam in Morning and Alprozolam in night Pancreatin BD Susp Mucaine MPS 2TSF BD Albendazole OD HS Blend diet

ECG shows s.tacycardia.do endoscopy,lft,echo.treat with beta blockers,ppis,and antacids

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Sinus tachycardia. Anxiety neurosis.APD. Antacids, Chlordiazepoxide, Antispasmodic helpful.. Amalpitatank ras, amalki swaras, Amritarisht, rasonadi vati,tab gasex, hingwashtak churna helpful..

Thanks Dr Anil Gangani Sir..
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P A T Anxiety Neurosis

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ECG- sinus tachycardia (normal) ?acute gastritis ? anxiety Usg abd and pelvis... Symptomatic treatment

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