Tachycardia & chest tightness
Chief Complaint 34 y/o male presented with tachycardia, chest tightness, cough and left lower abdominal pain. History Family history positive for MI in father. He does not drink but smokes 4 cigerretes/day. He is diabetic. No previous history of such incidents. No hypertension. Vitals BP: 130/80 mmhg, HR: 95 b/min. Resp rate: 19 breaths/min, Temp: 99.2 degree F. Oxygen saturation was 92% at room air. Examination Well oriented to time place and person but looks exausted. Lung examination shows decreased breath sounds on the left side. Cardiac examination was normal. Pain on palpitation inn left lower quadrant. Investigations WBC-7,850/mm3, Hb 13 g/dL, hematocrit 39%, platelets 244,000/mm3 Electrolytes and LFT are wnl, creatinine of 1.1 mg/dL Chest x ray shows no sigificant finding, ECG: WNL Echocardiogram: Rt ventricular function-hyperdynamic, Lt ventricular function was normal. Treatment Please give your valuable opinion.
Patient has predominantly respiratory findings ,like chest tightness ,cough, fever, tachypnoea, and reduced SPO2. Clinical exam shows decreased breath sounds left base. He is a smoker. Since xray chest is normal , better do CT chest. Abdominal ultrasound for LLQ tenderness. Need to rule out COVID pneumonia ,suggest RTPCR for COVID
ADVISABLE... RULE. OUT.. ACUTE MYOCARDITIS WITH TUBERCULOSIS NEEDS U. S. G./. C. T.. SCAN.... .... ...WHOLE. ABDOMEN ECHO
Fall in saturation along with cough, fever and tachypnea indicate respiratory pathology ? Covid 19 ? Pneumonia Adv X ray chest RT PCR for Covid 19 HRCT chest
HRCT thorax Throat swab RT PCR Homocysteine level.
Look for myocarditis Pul TB Covid 19
See for lipid profile and thyroid profile See for D dimer N treat accordingly
Rule out covid 19
Pneumonia? Covid 19 Do RT-PCR
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