Concluded Case

bradycardia

65 yr female come with complaint of epigastric pain and dyspnea since 5 to 6 days She is known case of HTN on amlodep AT No vomiting no nausea no loose motions No fever Bp 180/100 Pulse 53 /min Spo2 98% Temp 97f ECG attached kindly adv management

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Concluded answer

ECG shows sinus bradycardia No other abnormality on ECG This patient is in beta blocker - atenolol , which might have contributed to sinus bradycardia, Atenolol can be changed to ace receptor blocker X ray chest HRCT chest and 2 D Echo For evaluation of breathlessness Proton pump inhibitors for epigastric pain

All Answers

ECG shows sinus bradycardia No other abnormality on ECG This patient is in beta blocker - atenolol , which might have contributed to sinus bradycardia, Atenolol can be changed to ace receptor blocker X ray chest HRCT chest and 2 D Echo For evaluation of breathlessness Proton pump inhibitors for epigastric pain

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Uncontrolled hypertension needs to review the treatment Ecg is WNL except sinus bradycardia due to atenolol Presenting symptoms are likely more in concerned of gastritis I will shift the pt on telmisartan+chlorthalidone And cilnidipine 10mg

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NSR with sinus bradycardia. ? Atenolol effect Epigastric pain and SOB seen Accelerated HTN Suggest observation, troponin, serial ECGs, ECHO , and abdominal ultrasound

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ECG appears normal. Control BP . Advice for Cardiac markers, stress test and 2 D ECHO

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Chest leads r recorded at Half standard S.Bradycardia LVH with strain (v2)

ECG is normal Looking like accelerated htn Tab.cinod 10 mg daily 2 times a day Need follow up

First started treatment of HTN give nicardial..even bp not control this drug so start lobet infusion. Than Further investigation need for diagnosis Cbc S creat S electro Hrct of lung 2D echo

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