Chest discomfort with heaviness in left arm

A 40 year old male stressed out by work presented to OPD with complaints of heaviness in head since first visit, chest discomfort and heaviness in arm BP 150/90 Pulse - 88 I had started her on Embeta XR 25 OD Escitalent Plus HS Carvidon MR 35 BD Monit SR 30 OD He was relieved in chest discomfort and BP, but his headache aggravated, and I had stopped monit SR 30, he is better in his headache problem, but still little heaviness in head as presented on first visit persists I have also asked him to get refractive error assessed again Kindly give your valuable opinion on this case

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? STRESS..ANXIETY.. RELATED..HEADACHE.. ? MIGRAINE.. NEED'S.. OPHTHALMIC EXAMINATION.. ECG STUDY.. X-RAY STUDY.. HEAD .. PNS .. CTCE STUDY.. HEAD.. BRAIN..SOS..

Tnx Dr Anil Gangani
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Dear Dr Ajitji Don't you feel you should initiate for his ECG / 2D Echo cardiography ? Anxiety stress / Migraine / RE of eyes / Frontal sinusitis../ Tri germinal neuralgia..

I agree
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I feel sir- before starting treatment an ECG is must followed by cardiac evaluation with echocardiography, and Lipid profile . Treatment is on expectant lines. In such cases - when patient is reluctant to get ECG done which is a basic investigation in such a case - you can call some ECG technetian in your clinic and get it done in front of you . Many a times in such cases- I do the same

Actually sir I have said again and again to him to get his ECG done, but he always lands up without ecg, 3 visits already done. May be I will find out someone who could come and do the ecg, with portable one
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For chest discomfort Seroflo & Duoline rotacap inhalation through rotahaler sos Tension headache tab Xinobid 1 bd For eyes consult eye specialist

Thank you doctor
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Stress induced angina Pt has bp 150/90 for his age hypertensive Hence most likely hypertensive angina Certainly without ecg or 2decho we should keep him on Metaprolol Ecosprin Ppis Tranquillisers

Thanx dr Vinay Kumar
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Angina pain Anxiety disorder High BP nitya mridu virechan,rest light diet wid mahavat vidhvansana ras,swarnamakshi,praval pishti and giloy satva,,,matra according to age,,,and saraswatarishta wid ashwagandharishta

Consider nitrate headache. Evaluate for cardiac enzymes echo CD sos CAG. Treat as migraine headache.

Thank you doctor
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Monit sr gives such unbearable tension headache. Stop monit and if dtill needed do add Ecosprin Atorva/rosuvastatin. But before all ECG and even echo is must.

This headache can be tension type headache. But I would suggest an ECG to rule out cardiac origin of chest discomfort and heaviness in the arm.

Thank you doctor
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Rx abhyadi qwath BD galo ghan tab 1bd Panxhsakar powder HS for 7 to 10 days Shadbindu oil for daily nasya

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