A 55 yr old male with CC of giddiness and vomitings

 A 55 year old female housewife brought  to casualty cheif complaint  of  chest pain  along with giddiness, slurring of speech, and 2 episodes of vomiting .

Patient was apparently asymptomatic 15 years back . She has joint pain for which she uses medications .

HISTORY OF PRESENT  ILLNESS

Daily routine of the patient :

The patient used to get up at around 7/8 in the morning, used to do household work and have   food 3 times in a day.

Patient was complaining giddiness and slurring of speech and cheif complaint of chest pain not radiating to left hand.

No H/O palpitations ,No H/ O sweating.

Patient went to private hospital in narketpally and diagnosed to have high blood pressure 170/110 and referred to KIMS, narketpally.

   HISTORY OF PAST ILLNESS 


Not k/c/o HTN,diabetes, asthma,epilepsy,CAD



 


PERSONAL HISTORY 


Married


Occupation:Homemaker


Appetite: Normal


Diet: mixed


Bowel and bladder:regular


No known allergies


FAMILY HISTORY 


Not significant 

PHYSICAL EXAMINATION 


No pallor,icterus,cyanosis,clubbing,lymphadenopathy,edema


No ascitesVitals


Temperature:afebrile




PR:82/min


RR: 16/min


BP:140/90mm


Spo2:

Grbs:109 mg%


SYSTEMIC EXAMINATION 

No thrills

CVS- S1S2 ++


Inspection - chest wall is bilaterally symmetric


 Auscultation -  S1 and S2 heard




RESPIRATORY SYSTEM


- Position of trachea is central


- Bilateral air entry is normal


- Normal vesicular breath sounds heard


- No added sounds


PER ABDOMEN


- abdomen is non tender


- bowel and bladder sounds heard


Inspection - shape - scaphoid


Auscultation - bowel sounds heard 

INVESTIGATIONS





PROVISIONAL DIAGNOSIS:
Hypertensive Urgency

Management & treatment
Tab.Pan 40 mg 
Tab.Zoffer 4 mg
T.vertin 8 mg
T.promethazine


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