PakMediNet Discussion Forum : Medicine : a pt with epigastric pain ,sweating anh high B.P
last evening i saw a n old lady ,with history of epigastic pain lasting 1 hr,sweating .BP noted at that time was 200/120 mm hg.Her ECG shows no sighn of ischemia.Should be put on antianginal therapy or antihypertensives alone
Posted by: abidrana Posts: 19 :: 15-08-2002 :: | Reply to this Message
I think you cannot label the patient of ischemic heart disease only by epigastric pain and sweating. Her ECG was normal, and she had hypertension at that time. She should be monitored for chest pain again and should be advised Exercise stress test after 1 week when her BP gets controlled.
She should be put on Anti-hypertensive alone. However, Adding Tab. Aspirin would be wise enough in this regard.
Posted by: docosama Posts: 333 :: 15-08-2002 :: | Reply to this Message
Patient age is important to consider. I think BP should be controlled first. Meanwhile you should keep ischemic event in mind. Sometimes ECG can be normal despite ischemia. Cardic enzymes if possible should be done to ecclude IHD for sure.
quote:
abidrana wrote:
last evening i saw a n old lady ,with history of epigastic pain lasting 1 hr,sweating .BP noted at that time was 200/120 mm hg.Her ECG shows no sighn of ischemia.Should be put on antianginal therapy or antihypertensives alone
Posted by: nisar Posts: 2 :: 28-08-2002 :: | Reply to this Message
i think she is having ischemic event due to raised blood pressure .ecg can be normal . cardiac enymes should be done. BP and ischemic both should be treated
Posted by: cardinal s Posts: 6 :: 07-05-2003 :: | Reply to this Message