56 yr old lady with no h/o DM, HTN came to OPD complaining of chest pain and ghabrahat off'n' since 1 month. BP was 180/90. Rest normal. What is the line of management.



ecg showing saddle back st elevation and pr segment depression in multiple leads with pr elevation and st depression in avr more suggestive of pericarditis.do a 2d echo to rule out.

in emergency opd,pl lie down pt in cfortable condition with disprin+clopidril+atenol/amlo/telmi-re check after one hour ,if it is started 2b down ,measure after 2,4&6hrs and then let continue medicine as u started

Already go 4 lipid profile and give ecosprin 75 with telmi+clorthalidion

BP is quite high,I would have started with antihypertensive,anti anxiety drugs for a few days,lipid profile,if chest pain is suggestive of cardiac pathology then sorbitrate sos, TMT and regular BP monitoring

cont .

BP is now normal with SL nifedipine 5 mg stat. Now patient doesn't want to get admitted because of financial constraints. What is the best possible and affordable treatment I should prescribe now.

I have started Telmisartan + chlorthalidone (40+12.5), pantoprazole, nitrocintontin 2.6 mg and atorvastatin 20 mg.

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plz dun use sl nifedip ok its nt gd use only retard form nife ok cz it can drop bp v rapid whc is nt good...

Ecg looks to be towards LVH side.. Should counsel the patient on compliance with bp medication(also get fundoscopy;kft and lft done with it to see microvascular changes)Also get lipid profile done and start the drugs for it accordingly,along with low dose aspirin.

She never had any medications for HTN. I have started low dose aspirin already + atorvastatin 10 mg.

plz dont go with sl tablets for NO reduction it causes reflux tachycardia leads to angina.go with htn work up RFT

OK sir. will keep in mind that.

Missing v4 to v6

Anterior wall ischaemia.

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