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Suffering With Chest Pains. What Treatment Should Be Done?

Posted on Thu, 6 Dec 2012

Question: XXXXXXX admitted with chest pains shows eleavitons in ii,iii and avi what would u do?

Answered by Dr. Prabhakar C Koregol (16 minutes later)

Hi,
Thanks for writing to us.
The history that you have provided seems like typical case of an inferior Myocardial infarction and best way forward would be to go ahead with Primary angioplasty (after having given some premedication). If there is no primary PCI facility, we can also consider lysis. However if the diagnosis in doubt, then further evaluation with cardiac enzymes and Echocardiogram would be needed.
Hope that helps
Let me know if you have any more questions
Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Prabhakar C Koregol (39 minutes later)

How are vitals on admititng? and breathing
his bp wne tdoswn to 95/50 what would you do?

Answered by Dr. Prabhakar C Koregol (7 hours later)

Hi
Thanks for writing back.
I would like to know that the BP has gone down to 95/50mmHg from what initial level. If presentation BP is same than the management remains same as described in the initial reply. If his BP has been much higher and suddenly drops to this level than we need repeat ECG and Echo to look for any fresh changes. Than depending on LV (left ventricular) filling pressure and Killips class we can either give fluids or inotropes;. Also need to expedite the process of Primary angioplasty
Hope that helps
Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Prabhakar C Koregol (2 hours later)

He has gon dow. Hows his ekg?

Answered by Dr. Prabhakar C Koregol (23 hours later)

Hi,

I did not understand your query? Did you forget to attach an ECG or something?

If you wish to post the EKG, you can use this site's uploader.

Awaiting your reply...

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Prabhakar C Koregol (21 minutes later)

No ekg but woudl u do if bpp is still low?

Answered by Dr. Prabhakar C Koregol (34 minutes later)

I will need more clinical information to answer this query. Details about lung congestion; LV function; the treatment that is currently on; etc., will be needed. Discuss with the treating doctor.

I will be available for assistance if you need it.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Prabhakar C Koregol (42 minutes later)

lfv function 85 percent
bp 100/60 pulse 80.

Answered by Dr. Prabhakar C Koregol (20 hours later)

LF EF 80% doesn't seem correct for the clinical scenario you have discussed. However with BP and pulse you mentioned, if he is comfortable and on minimal medicines he can continue to be on the same.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Prabhakar C Koregol (2 hours later)

What woud be the correct?

Answered by Dr. Prabhakar C Koregol (9 hours later)

Hi,

Generally such patients would have lower EF in the range of 35-50%

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan