CARDIOLOGY(C)

 A1.

 Evolution of symptomatology and event timeline - 
Past-
10yrs ago - Operation for Hernia
Since 2-3 yrs - Facial puffiness
1 yr ago - SOB grade II
1 yr ago - was diagnosed with Hypertension.
When the patient came to OPD - 
Since 2 days - SOB which progressed from Grade II to Grade IV.
Since 2 days - Decreased urine output.
Since 1 day - Anuria
After admission - 
CT scan - Showed dilated pulmonary vessels and thrombi in the atria.
2D Echo - Showed LV dysfunction.
Anatomical location - Atria (SA node)

A2.

  • Digoxin - It is a cardiac glycoside
             MOA - It increases intracellular sodium that will cause an influx of calcium in the heart and cause an                     increase in contractility. It is vagomimetic. 
             Indications - Heart failure and arrhythmias. 
  •          Carvediol - It is a beta-blocker.
             MOA - It blocks the beta receptors and lowers the heart rate, blood pressure and strain on the heart.
             Indications - Hypertension, heart failure, LV dysfunction with MI.
  •          Heparin - It is an anti-coagulant
             MOA - It produces its major anticoagulant effect by inactivating thrombin and activated factor X                                through an antithrombin dependent mechanism. By inactivating thrombin, heparin not only                                prevents fibrin formation but also inhibits thrombin induced activation of platelets and of factors V                      and VIII.
             Indications - Prophylaxis and treatment of venous thromboembolism and pulmonary embolism; Atrial                      fibrillation with embolization ; chronic consumptive coagulopathies.
  •           Acitrom - It is an Oral anti-coagulant
             MOA - It inhibits the reduction of Vitamin K by Vitamin K reductase. This prevents carboxylation of                           Vitamin K dependent clotting factors, II, VII, IX, X and interferes with coagulation.
             Indications - Thromboembolic diseases such as DVT, Coronary occlusion
  •           Cardivas - It is an adrenergic blocker
               MOA - Reversibly binds to beta adrenergic receptors on cardiac myocytes. Inhibition of these                                receptors prevent a response to the sympathetic nervous system, leading to decreased Heart                           rate and contractility
               Indications - Hypertension, Angina and heart failure.
  •           Dytor - It is a diuretic. Contains Torsemide + Spironolactone
               MOA - Through its action in antogonizing effect of Aldosterone, spironolactone inhibits the exchange of sodium for potassium in the distal renal tubule and helps to prevent potassium loss.
               Indications - Edema, Hypertension.
  •           Taxim - It is a cephalosporin antibiotic.
              MOA - It is bactericidal through inhibition of cell wall synthesis.
              Indications - Treatment of infections of throat, airway and urinary tract ; Typhoid fever.
  •          Thiamine - It is Vitamin B1.
              MOA -  Rapid restoration of Thiamine levels
              Indications - Wernicke's encephalopathy, infantile beriberi etc.
  •             Inj. HAI - It is a short acting insulin.

A3.

A4.
HTN, physical inactivity and obesity in this pt.

A5.
Anticoagulants being given to patient , therefore CVA and  for predicting future ischemic attacks we do the above  tests


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