Chest tightness = anxiety
Missed = Ventricular ectopics
Thumping heart= Atrial myxoma
- SVT= Irregular heart beat+ palpitation for 3 hrs + PR- regular and 154 bpm following carotid massage falls to 80 bpm
- Ventricular ectopic= long standing anxiety+ heart skips a beat+ occurs before sleep+ Palpitations never sustained
- PSVT( Paroxysmal supraventricular trachycardia)= 2 hr h/o rapid palpitations+ light headedness+ pulse 170bpm regular+ BP 168+ h/o similar episodes in the past
- Complete heart block= h/o slow pounding heart + angina worse lately+ Ditiazen prescribes
- Atrial fibrillation= post op
- Heart block= HR 30bpm + post MI 3 hrs
- Sinus trachycardia= post op pt + hypotensive after bleeding from op site
- VENTRICULAR ECTOPIC= Fit man+ PR 60bpm with occasional irregularities
- SINUS BRABYCARDIA= long distance runner + pulse rate 52 bpm
- HTN>>> Bendrofluzide >>> dizziness falls worst in the morning >>> Orthostratic htn >>> Stand and lying BP
- 69 yr old man+ Preogressive h/o Angina and dizziness on exertion + heart murmur present >>>> Inv: of choice ECHO >>> ??? Aotic stenosis
- ** 70 year old female + h/o mild stroke + On Aspirin for 5 years>>> increasing breathlessness and light headedness >>> Inv : FBC >> ??? anaemia
- Treated for seizures 6 month back >> dizziness + poor balance+ nystagmus ( past 2 weeks)>>> Inv : Serum drug level >>> ???? Phenobarbitone toxicity
- ?? SUPRAVENTRICULAR TRACHYCARDIA= Medication Isosorbide mononitrate + Aspirin >>> dizziness + Palpitation lasting few hours occurs almost everyday>>> Inv : of choice ambulatory ECG
- Inferior MI ( II III aVF ST elevation ) >>> chest pain 2 hours back lasted 1 hour >>> Innitial Rx >> Isosorbide mono-nitrate
- h/o Inf. MI and thrombolysed 1 year ago>> present with 3mm St elevation V2-V4 >>> Rx of choise r-tpa ( recombinant tissue plasminogen activator
- Chest pain + breathlessness >> ECG: Inf wall MI ( II III aVF depression) + narrow complex trachycardia ( SVT)>>> Since the pt is compromised due to MI >> Innitial Rx of choice : Heparin + DC cardioversion
- Atrial fibrillation >> HR 160 bpm + irregularly irregular pulse + Dizzy >> Rx: B –blocker Atenolol
- Anginal symptoms increases from walking up hill to rest >>> Unstablee Angina
- Excercised induced ECG shows ST depression + Cornary angiogram normal>>> STABLE ANGINA
- Angina more frequent on “ minimal” exertion >>> ECG: LVF >> BP =140/ 100 + enlarged heart + systolic murmur radiating to the back>> Dx: Aotic stenosis >> Supravalvular
- CORONARY ARTERY SPASM (Prinzmental angina)= typical s/s of angina usually occurs at rest. During episode ECG shows ST elevation>>> rapidly returned to normal as the pain resolved>> Cardiac enzymes normal
- Acute anterior MI>> Aspirin and analgesia given>> Buccal nitrate ( no mention of STEMI or NSTEMI)
- h/o MI a month ago>>> presents with acute breathlessness + basal crackles >> Rx : diuretic
- CARDIAC PACING= MI 1 week ago + now feels faint and PR 36 bpm = complete heart block
- CARDIAC PACING= Complete heart block= pt in CCU (LVF) + inf wall STEMI+ PR 30bpm + BP 70/50 mm Hg
- 6 weeks h/o fever , breathlessness and weight loss + childhood h/o rheumatic fever+ Osler’s node present+ low pitch diastolic murmur and harsh pansystolic murmur= INFECTIVE ENDOCARDITIS= Rx: Benzylpenicillin
- 47 years+ blackout ion exertion+ Family history of sudden death at young age + mitral murmur present+ thickened interventricular system on echo >>>> Mx: refer to surgeon for myomectomy
- SVT not slowed out with Adenosine>>> Cardioversion
- CCF worse despite furesemide >>>> Mx : Add Thiazide diuretics
- Thiazide ( Loridazole ) >>> repeated fall >> Osthostatic HTN >> Review dose
