61/Female known dm. Presented with Epigastric Pain Attached Ecg known Hypothyroidism on Treatment Attached ECG

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61 F DM = PRESENT STATUS NOT KNOWN HYPOTHYROID = POSSIBLY CONTROLLED ON TREATMENT ECG = ABSOLUTELY NORMAL EPIGASTRIC PAIN & VOMITING ---------------------------------------- CAUSES CAN BE 1 IN A DIABETIC PT A ( UNCONTROLLED D M ) DIABETIC KETOACIDOSIS ------------------------ LOOK FOR = BLOOD SUGAR Na+ k+ Hco3 - urine sugar ketone bodies B Diabetic gastroparesis 2 acute gastritis 3 cholecystitis / choleliathesis USG UPPER ABDOMEN 4 acute pancreatitis / ch calcific pancreatitis ( diabetic pt ) = blood amylase lipase cbc CT upper abd 5 acute appendicitis = initially pain starts midline epigastric region later shifts to right iliac fossa Blood = look for leukocytosis usg = abd 6 epigastric pain & vomiting is not Useal presentation of M I
ECG normal tracing..
NORMAL ECG EPIGASTRIC PAIN CAUSES 1 ACUTE GASTRUTIS / PUS 2 CHOLECYSTITIS CHOLELITHIASIS 3 PANCREATITIS 4 ACUTE APPENDICITIS EARLY STAGE LATER SHIFTS TO RIF 5 DIABETIC KETOACIDOSIS 6 NOT USUAL BUT CAN BE IN M I 7 PEPTIC PERFORATION 8 RUPTURE ABD AORTA . ANEURISM IN UNCONTROLLEF D M = DIABETIC KETOACIDOSIS TO BE THOUGHT SERIOUSLY
ECG -Sinus rhythm. Known Hypothyroidism report not mentioned, epigastric pain and vomit may be due to acute gastritis. Treat as gastritis ,APD, if symptoms persists then needed further investigation. CBC,B sugar f,pp, HBA1c, USG whole abd,TSH, LFT, kft.
Pt is diabetic and hypothyroidism C/o epigastric pain are likely to be related to APD Present ecg is WNL
Sorry Sir. Posted earlier. You again posted wrongly. I have given answer
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