Unstable Angina, Next Best step?
60/F, DM,HTN, C/o Chest Pain at Rest ECG shows Ant-Lat strain ECHO- EF64%, IVS thickening , TrpT negative Now on- Ecosprin 75 OD Rosuvas20 OD Metoprolol SR 25 OD Telmisartan 40 OD Metformin 500+ Lipaglyn 4 OD GTN-2.6- -8AM/4PM Next Best step?
If there is history of Unstable Angina the best next step is to arrange for coronary angio followed by PCI or CABG depending on the results.
T wave inversion in v1 to v5 s/o ischemia If pain is refractory to Medical management,,, next best investigation is Cath U can start LMWH with I.V intro
Suggest Angio ,and stenting. If ECG shows diffuse atherosclerotic changes, consider CABG
CAG---CABG/PTCA
Cases that would interest you
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A 45year old male presented with complaints of Dyspnea on exertion and pain in chest left side esp after heavy metals and exertion. T wave inversion are present in V3,V4,5,6,I,avl and ST depression in lead II I have started treatment for CAD and started on lipikind AS at bedtime. please give your valuable inputs about further workup and treatment.
Dr. Ajeet Singh1 Like19 Answers - Login to View the image
54year male presented with complaints of chest pain since 4hrs...h/o sweating..heartburn... not relieved after taking antacids k/c/o dm on regular treatment
Dr. Manjunath Ilager1 Like17 Answers - Login to View the image
67 yrs lady she has chest pain bp 190/100mmhg what u say about this ECG
Dr. Mahesh Labde0 Like20 Answers - Login to View the image
one hour chest pain with ghabrahat vital stable please coment on ecg
Dr. Ramavatar Bairwa3 Likes18 Answers - Login to View the image
62 yrs smoker male presented with progressive dyspnea and chest pain since last 4 to 5 hrs. his BP 130 / 80mmhg spo2 97% diagnosed as acute coronary syndrome. loading dose of antiplatelets statins with IV nitrates nikorandil LMWH s/ c started. gp2b 3a inhibitors started. ECG repeated after an hour. clinically Patient is improved. my point is , To thrombolysis or to treat as unstable angina , which is correct approach in such cases?
Dr. Sandeep Ghodekar6 Likes19 Answers
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