10-11-2007, 11:51 AM
Hotobhago or anyone please!!! for steps with pt AS
Thanks in advance
Thanks in advance
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severe aortic stenosis ccs - welcome1
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10-11-2007, 12:01 PM
it would depend on the presentation
but the main points would probably be 2d echo cardiothoracic consult for aortic valve replacement digoxin carvedilol I and O morphine if with chest pain or pulmo edema at least that's how i would do it... do they really give such tough cases for ccs?
10-11-2007, 12:55 PM
Pt presented with chest pain and light headedness. Why digoxin and what is i and o.
thnks honeysuckle
10-11-2007, 01:17 PM
pt comes tro the ER with SOB/syncopal/chest pain
SOB iv acsess. pulseoxymetry.o2.caridiac monitor.12 lead ecg, finger stick glucose. cardiac enzymes limited exam will rule out chest desease, pneumothorax, pneonitis, copd murmur will be heard confirming diagnosis syncopal episoded: neuro exam will be normal, glucose will be normal chest pai: ECG will be non-mi features Once u know that an AS murmur is present start NS, Nitroprusside, lasix to decrease afterload. Then do 5 min Bp checks asthe pt is on nitroprusside Ask for cbc.BMP,lft. pt/ptt, FOBT, 2decho, ctscan brain, electrolytes, UA, Lipid profile If the pt is in CCF( as will be shown by the chest exam , JVD 2decho) start digoxin..otherwise dont ..in any case digoxin will not have any acute effect Pt improves shifty location to ward, put folley maintain out put chart salt restricted diet, aspirin see if u can DC O2 oan IV fluids and make oral meds 2 D report says AS. take surgical opinion as the pt is symptomatic Dc the patient on Aspirin low salt diet seat belt safe sex no smoking moderate alcohol excercise counsel medication counsel counsel antibiotic prophylaxis before dental procedure
10-11-2007, 01:36 PM
lasix to decrease afterload?????
I think diuritics dec. preload hoto not afterload.
10-11-2007, 01:45 PM
sorrry mistake.. lasix for preload and nitroprusside for after load
10-11-2007, 02:45 PM
Hoto is right, I thought of digoxin because I "predicted" the case had CHF since it was an ER presentation.
I and O is input and output...again because I thought the patient was in CHF that was a real tough one! did it end early? well, cheer up, you are done. just await your scores, and pray, pray, pray!!! gluck
10-26-2020, 04:53 AM
He also describes the signs doctors should look out for in their patients, including heart sounds, blood pressure and pulse.
Heart Diagnosis |
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