1.
ACS IN FAILURE
74 y/o Indian male
u/l: HTN
p/w:
1) central chest pain x1/7
burning sensation
2) SOB x1/7
Sudden onset
3) bilateral LL swelling
Otherwise:
No fever
No URTI sx
CXR: Bilateral lower zone consolidation
ECG: LBBB
IMPRESSION: ACS IN FAILURE
PLAN:
1) Admit ward
2) Start ACS regime: s/c Axitra 2.5mg OD x3/7,Tab Cardiprin 100mg OD. Tab Plavix
75mg OD x1/12, Tab Bisoprolol 1.25mg OD, Tab Atorvastatin 40mg ON
3) v/s monitor
4) IV Lasix 40mg OD
5) ECG upon chest pain
6) ROF 800cc per day
7) Strict I/O charting
IX: Trop T, RP OD, ECG OD, FBS, FLP CM