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  #1  
Old 05-17-2014
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Default Any feedback Plz.. PN.....

49 yo M, c/o chest pain.
- started 40 min ago, constant, he was sleepin when the pain woke up suddenly.
- 7/10, middle of chest, radiated to neck and left arm, pressure-like.
- The patient has dyaphoresis, dyspnea, and is feeling nauseated, there are no vomiting, cough, palpitation.
- He has had similar pain before, but less severe and aggrav by heavy meals, allev by antacids.
ROS: No Abdominal pain, diarrhea/constipation
Meds: Maalox, diuretic. ALL: NKDA. FH: Noncontributory
PMH: HTNx5years, treated with diuretic, Hypercholesterolemi, treated with diet (no compliant with diet), GERD, treated with antacids
PSH: No trauma or hospitalizacion.
SH: 1 PPDx25 years, stopped 4 months ago. Drinks once in a while. no drugs. works as clerk. no sex due to pain.

Patient is in acute distress. Coopertaive
VS: wnl except for BP 165/85 mmhg RR: 22 min.
neck: No jvd, no carotids bruits.
Heart: PMI not displaced. Normal s1/s2; rrr; no m,r,g
Lungs: No chest wall tenderness. clear breath sounds bilaterally, clear to percussion. no rhonchi, rales or wheezing. TVF normal.
Extremities: no edema, cyanosis. Radial, posterior tibilar and dorsalis pedis 2+ and symmetric.

Myocardial Infaction

Chest pain BP 165/85 mmhg RR: 22 min.
7/10, middle of chest, PMI not displaced. Normal s1/s2;
radiated to neck and left arm, pressure-like. rrr; no m,r,g
The patient has dyaphoresis, dyspnea, No chest wall tenderness
and is feeling nauseated No jvd, no carotids bruits
HTNx5years, treated with diuretic Hypercholesterolemi, treated with
diet (no compliant with diet)

Angina

Chest pain BP 165/85 mmhg RR: 22 min.
7/10, middle of chest, PMI not displaced. Normal s1/s2;
radiated to neck and left arm, pressure-like. rrr; no m,r,g
The patient has dyaphoresis, dyspnea, No chest wall tenderness
and is feeling nauseated No jvd, no carotids bruits
HTNx5years, treated with diuretic
H/o similar pain
Hypercholesterolemi, treated with
diet (no compliant with diet)

Aortic dissection

Chest pain BP 165/85 mmhg RR: 22 min.
7/10, middle of chest, PMI not displaced. Normal s1/s2;
radiated to neck and left arm, pressure-like. rrr; no m,r,g
The patient has dyaphoresis, dyspnea, No chest wall tenderness
and is feeling nauseated No jvd, no carotids bruits
HTNx5years, treated with diuretic
Hypercholesterolemi, treated with
diet (no compliant with diet)
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  #2  
Old 05-17-2014
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Default

good,, passed in PN,,
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  #3  
Old 05-17-2014
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Default

Quote:
Originally Posted by kamidi View Post
good,, passed in PN,,
Thanks so much for your answering.

I'm a spanish speaker and I'm really worried about my PN..
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