Tushar 13.13
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Transcript of Tushar 13.13
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Keep off your cell phonesilent please!
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WEEKLY DEATH PROFILE 0F CARDIOLOGYDEPARTMENT,NICVD.
FROM 06-11-12 TO 12-11-12
Presenter:
Dr. Asif Zaman TusharMD Cardiology, 3rd part student
NICVD
Moderator
Dr. Nupur kar
Assistant Professor of Cardiology
NICVD
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Comparison between total admission & death
7%
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Age and sex distribution of expired patients:
Age No. of expired patients
60yrs 18
Total: 53Male : 36
Female : 17
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Primary causes of death:IHD:
STEMI : 15UA : 07NSTEMI : 05
Cardiomyopathy : 12Valvular heart disease : 04Congenital Heart disease : 03Arrhythmia : 7
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Secondary causes contributing to death
Cardiogenic shock : 18Acute LVF : 20Complete heart block : 8Electrolyte imbalance : 4Others : 3
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Risk factors for IHD Co-morbidconditionsSmoking 17 COPD /
Br. Asthma12
HTN 22 CKD 5DM 14 CVD 2Dyslipidemias 12Positive family history ofIHD
10 ARF 2
Risk factors & Co-morbid conditions
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Discussion of death of selected patientParticulars of the patient:
Name : Sattya pal
Age : 65 years
Sex : Male
Address : Muradnagar , Comilla.
Date and time of adm. : 06.11.12, 01:55 am
Date and time of death: 06.11.12, 04:10 am
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CHIEF COMPLAINTS :Chest pain for 10 hrs.
HISTORY OF PRESENT ILLNESS:According to the patient, he was reasonably well 10 hrs back.
Since then he developed compressive chest pain which radiates
towards left arm associated with vomiting and sweating .Patient was normotensive and nondiabetic.
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H/O past illness :Nothing contributory
Family history:Nothing contributory.
Personal history:Non- Smoker
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Clinical examination : (on admission)GENERAL EXAMINATIONS:Anxious
ANAEMIA - absent
JAUNDICE- nil
OEDEMA- nil
PULSE- 92/MIN, regular
BP 100/70 mmhg
JVP - not raised.
Respiratory rate: 20/min
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Clinical examinationcontinued
Cardio Respiratory system :HEART: Normal.LUNGS : Vesicular breath sound.
OTHER SYSTEM: Revealed no abnormality
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DIAGNOSIS ON ADMISSION
Acute MI Inferior with
posterior extension
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TREATMENT on admissionBed restO2 Inhalation: 4 lit/minTab. Aspirin 300mgTab. Clopidogrel 300mgTab. Atorvastatin 20mgInj. StreptpkinaseInj. MorphineInj. Prochlorperazine
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Treatment and follow up
Follow up at 3:00 am on 6.11.12
P/C- breathlessness
O/E
Pulse-112/min
BP- 85/60 mm of Hg
R/R- 26/minheart- soft S1/ S2.
Lungs- fine bilateral basal crepitation.
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Rx given
Inj. Frusemide Inj. Dopamine - 5ml/hr
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Treatment and follow up
Follow up at 3:30 am on 6.11.12
Pt developed cardiac arrest.
CPR started immediately and endotracheal intubation was done. All
other necessary medications were given. CPR continued for 30
minutes but patient did not revert back. Patient was declared dead at
4:00 am.
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PRIMARY CAUSE OF DEATH:
AMI Inferior with posterior extension
SECONDARY CAUSE OF DEATH:
Acute LVF
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WHAT COULD BE DONE IABP
PCI .
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