Male, 65 years old. Chief complaint: paroxysmal chest pain for 2 yrs, aggravate for 3 days. Present history: 2 yrs ago,
Posted: Thu Jun 09, 2022 5:14 pm
- Male 65 Years Old Chief Complaint Paroxysmal Chest Pain For 2 Yrs Aggravate For 3 Days Present History 2 Yrs Ago 1 (307.86 KiB) Viewed 182 times
what are the candidate differential diagnosis?
give some of the treatment principle related to this case
Male, 65 years old. Chief complaint: paroxysmal chest pain for 2 yrs, aggravate for 3 days. Present history: 2 yrs ago, the patient had retrosternal pain after fast walking, stuffy pain at the middle of the stemum, and it was gradually relieved after rest for 3-5 mins. 3 days ago, the pain happened again, accompanied by sweating and nausea, which last for 20 mins. The attacks were more frequent than before, and he was sent to hospital for further diagnosis and treatment. Past history: Hypertension for 20 yrs, the highest BP is 170/110 mmHg, taking Nifedipine tablets 30mg/d Physical examination: T 36.5°C, P 104 bpm, R 20 bpm, BP179/97 mmHg, SPO₂ 95%, The patient is consciousness and clear speech, and cooperate to examination. Normal breath sound. No abnormal rales were heard. Heart rate is 104 bpm, premature beat can be heard, about 4-5 times/min, no murmurs. His abdomen is soft, he has no tendemess and rebound tenderness, liver and spleen are not palpable. Auxiliary examination: Blood routine: WBC 9.8*10%/L, N 59.4%, Hb 127 g/L, Plt 191*10%/L, Hct 38.5%. Glu 6.6 mmol/L, K 3.3 mmol/L, Na, 138 mmol/L, CI 102 mmol/L, lac 4.0 mmol/L, ECG as follows:
ار است در این AVR AVVL VI ه سهل V4 VS Questions: Q1. What is your primary diagnosis? Q2. Please outline the evidence that lead to your diagnosis. Q3. What are the candidate differential diagnosis? Q4. Give some of the treatment principle related to this case. Your des