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PRESENTED BY- Dhaivat Joshi (FINAL YEAR B.PHARMACY) Hari Om Pharmacy College

CASE PRESENTATION. PRESENTED BY- Dhaivat Joshi (FINAL YEAR B.PHARMACY) Hari Om Pharmacy College At. Ambav, Ta. Thasra, Dist. Kheda. ISCHEMIC HEART DISEASE. PATIENT DETAILS. NAME: XYZ AGE: 61year WEIGHT: 75 kg INPATIENT No:68129

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PRESENTED BY- Dhaivat Joshi (FINAL YEAR B.PHARMACY) Hari Om Pharmacy College

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  1. CASE PRESENTATION PRESENTED BY- Dhaivat Joshi (FINAL YEAR B.PHARMACY) Hari Om Pharmacy College At. Ambav, Ta. Thasra, Dist. Kheda.

  2. ISCHEMIC HEART DISEASE

  3. PATIENT DETAILS NAME: XYZ AGE: 61year WEIGHT: 75 kg INPATIENT No:68129 ADDRESS: BARODA HOSPITAL NAME: BARODA HEART INSTITUTE AND RESEARCH CENTER, BARODA D.O.A: 06/12/2007 CONSULTANT NAME: Dr. PANKAJ VYAS (M.D,D.M)

  4. SOCIAL HISTORY: Vegetarian • FAMILY HISTORY: Father had cardiac problem. • DIAGNOSIS : Ischemic heart disease and • obesity • ASSOCIATED DISEASE: None • PAST MEDICATION HISTORY: Nil • COMPLAINTS: CHEST PAIN, • HEAVYNESS

  5. HAEMATOLOGY

  6. DIFFERENTIAL WBC COUNT

  7. ESR- 1hr( Westerngreen Method) :- 28mm/hr (normal range – M-1-7, F-2-10) • BLOOD Group:- ‘A’ • Rh Factor:- POSITIVE • Platelet Count:- 165000/ cmm (1,50,000-4,00,000)

  8. BIOCHEMISTRY

  9. COAGULANT TEST

  10. ESTIMATION OF SERUM ELECTROLYTE METHOD – AUTOMATIC AVL 9130 ELECTROLYTEANALYZER ESTIMATION OF BLOOD SUGAR POST LUNCH {GOD-POD}

  11. SECTOR ECHOCARDIOGRAPHY • Ischemic Heart Disease • Hypokinesia of Basal and Mid Inferior segments • LV show concentric hypertrophy • All cardiac chamber are normal in dimentions. • LV systolic function is normal at rest [ LV EF-56%] • E/o regional wall motion abnormality at rest. • Cardiac valves are normal in structure & cxcursions. • RVOT & MPA are normal, NO e/o mass/clot seen.

  12. COLOUR FLOW, CW, PW &HAEMODYNAMIC DATA • Normal flow across all cardiac valves. • LV diastolic dysfunction. • No MR/ TR. trivial AR. • No E/O Lt--> Rt shunt

  13. CONCLUSION • Ischemic Heart Disease. • Good LV systolic function. • Concentric LVH with diastolic dysfunction. • E/o resting regional wall motion abnormality. • Mildly Sclerosed AV with Trivial AR. Normal PA Pressures.

  14. MEDICATIONS:-

  15. DRUG INTERACTION • ATOCOR [ATROVASTATIN] = 10-20mg DONOT CONSUME WITH ALCOHOL, IF HEPATIC INSUFFICIENCY,COLESTIPOL, ANTACID, DIGOXIN ERTHROMYCIN. • CARDACE [RAMIPRIL] =1-5-5mg DO NOT TAKE WITH NSAID’S AS IT REDUCES ITS ACTIVITY. • CLODREL-FORTE [CLOPIDOGREL+ASPIRIN] = 75+162.5mg DIGOXIN ,WARFARIN & WITH NSAIDS INCRESS G.I.T. BLOOD LOSS.

  16. TO AVOID… • FASTING • REFINED FLOUR LIKE MAIDA,SAGO. • NUTS,WALNUTS,CASHEW,GROUNDNUT,PANEER,BUTTER. • CANNED/TINNED FOOD. • POTATO,BEETROOT,YAM,SAGO,RAW BANANA,SURAN. • EGG YOLK. • FAST FOOD/ AREATED DRINKS • RICE AT DINNER TIME • SWEET PRODUCTS WITH EXCESS GHEE. • MUTTON,BEEF,PORK. • ALCOHOL/ SMOKING/ TOBACCO • AFTERNOON SLEEP.

  17. PREFER… • WALK AT MORNING & NIGHT. • HAVING FOOD AT RIGHT TIME • 6 MEALS A DAY TO AVOID HYPOGLYCEMIA. • CARRY SWEET IN POCKET TO AVOID HYPOGLYCEMIC STROKE. • SKIMMED MILK. • CONSUME MORE SALAD & VEGETABLE • ONLY EGG WHITE • OIL USE MUST NOT EXCEED(15gm)/DAY/PERSON. • REGULAR EXERCISE. • UNREFINED CARBOHYDRATE • HAVE WHOLE FRUIT. • REGULAR CHECK UP.

  18. PATIENT COUNSELLING • EXPLAIN THE SIGNS AND SYMPTOMS OF CIRCULATORY EVENTS CAUSE BY A TIGHT CAST THAT REQUIRES IMMEDIATE TREATMENT. • DISSCUSS THE SIGNS AND SYMPTOMS OF EVENTS. • TEACH THE PATIENT CAUSE OF ARM PAIN & TREATMENT. • WEIGHT SHOULD BE CONTROLED. • PATIENT IS REQUEST NOT TO ALTER DOSE OR CHANGE THE DOSAGE FORM • PATIENT SHOULD DUELY VISIT DOCTOR AND HAVE THEIR LIPID & OTHER CONCERNE PROFILE UP DATEDED. • DONOT PULL OR PUSH ANY HEAVIER LOAD. • NO BRISK WALKING. • YOGA EXERCISE SHOULD NOT INCLUDE EXTENSIVE STRECHING OR UPSIDE DOWNING.

  19. REFERENCES:- • www.indiamediworld.com • www.drugdigest.com • Tripathi K.D, 2004 “ Essential Of Medical Pharmacology”, 5th Edition , Jaypee Publication Page No: 465,567,444 • Drug Today, Vol-1&2, Ready reckner of current medical formulations, pg no-256,1264,271,717.

  20. THANK YOU. THANK YOU

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