Chest tightness and palpitation

Chief Complaint A 49 year old female presented with the complaint of chest tightness, palpitations and giddiness of 5 hours and had tachycardia. History She smokes 3 cigarettes/day and drinks alcohol twice a month for the past 10 years. She is diabetic which is well controlled by medication. She has no other past medical or surgical history. *Vitals: BP: 135/85 mmhg, HR: 78 bpm, Resp rate: 21 bpm, Temp: 98.3 degree C. Investigations ECG shows normal sinus rhythm with RBBB and LAFB - bifascicular block. MRI was done which shows fibrosis in basal lateral wall. CBC normal, Thyroid function was normal. Troponin I was 0.61 ng/ml. Potassium and magnesium levels - Low. Treatment Need your opinion on the treatment plan.

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Cardiac enzymes and risk markers. Considering her age life style and risk factors, CAG is advisable. Further medical management, life style modification, diabetic and electrolytes correction is expected.

Presentation of tightness in chest, Troponin I is slightly raised, RBBB with LAHB All above finding can be secondary to ischaemic heart disease Adv 2 D Echo, stress test / TMT, SOS coronary angiography Correct underlying Electrolyte disorder

I H D Troponin is slightly raised RBBB with LAHB. Needs further investigation and evaluation to conclude particularly 2 D ECHO TMT. Regular monitoring and constant evaluation required under cardiologist.

Thanks Dr Dinesh Gupta
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prabhakar vati refrence through bhaishjay ratnawali from hridrog prakran. it is mentioned for all type of hridrog. as it contains shilajatu so it is very good result on kaphaj dushti. major contents of prabhakar vati is swarnmakshik bhasm,lauh bhasm, abhrak bhasm,shilajatu ,vanshlochan with arjun ras bhavna. in my practice genreally i use it for patient related to heart palpitation. (adding of liver tonic also)

Spondylosis angina. Ad upper abdominal investagatio and history are important

POSSIBLY SINUS .. RHYTHM ...... R. BBB L. A FB FIBROSIS. IN. BASAL...LATERAL. WALL NEEDS ELECTROLYTES. CORRECTION AND ECHO

Fabry disease X chromosomal disease Affect heart Opinion of endocrinologist Cardiologist

Chest physiotherapy and usg guided FNAC to rule out malignancy

Indicative of a heart disease,MI ,CAD,L VH, arrthymmia. Electrolyte imbalance to b corrected. Cardiac profile, echo,Color Doppler,MRI , Anxiolytocs, Arjuna risht, helpful. Cardiologist opinion..

Manage on the line of NSTEMI

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