45 yr old fatty lady complains of retrosternal pain radiating to both arms...agravated on wlking relieved on rest..ecg n blood test r normal..hb 10 gm%

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As per information given by the doctor . ECG and blood tests are normal.And presuming that cardiac enzymes are also normal MI is unlikely.Though ishcaemic pain can occur in anaemia though it is mild and particularly when pt is hypertensive as it may appear as shape of cardiac shadow is boot shaped.Go for echocardiography instead.

This seems to be a case of exertional angina relieved by rest. probably she is also having high BP. She should be advised to take sorbitrate 5 mg sublingually while in pain and if she gets relief within 2 to 3minutes, the likelihood of angina is more. She should be advised to go for TMT and and other cardiac enzymes which will differentiate in diagnosis.

sir is there cardiomagaly as wel? bp z normal
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do ECg and trop R

Is there any increase in heart size as wel?
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post EkG. do trponin and cpk/mb lipid profile treat symptomatically

ecg n lipid profile NAD
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if all symptoms are aggravate by work, walking, or activities and and pt. get relief by rest its its defiantly m.i.

cardiac marker like CPK, cpk -mb and troponin are released only in case of MI.so with the investigation of cardaic marker we can not rule out other ischaemic condition like angina so go for ,,stress ECG. and. 2D echo

B.P ?

yes. do ECG and troponin
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rule out M.I

may b costocondritis plz try muscle relaxent vit d3 calcium pantocid DSR n syp sucralphate

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