19 year old female came with c/o difficulty in breathing and chest pain

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19 year old female came with c/o difficulty in breathing and chest pain since 1 hour


History:

2 years ago patient was diagnosed with hyperthyroidism using Tab .Carbimazole 20 mg po/od and propranolol on and off whenever she had palpitations.

Jan 2021 - H/O COVID 

Jan 2022 - H/O COVID +, was diagnosed with mitral valve prolapse and was put on imedication which is unknown and Tab carbimazole dose was increased to 20mg bd due to altered TFT report.

Patient was apparently asymptomatic till 7pm today , patient developed chest pain , difficulty in breathing, palpitations which lasted for 10 mins but chest pain continued so she was brought to our hospital.

Not a k/c/o diabetes mellitus, hypertension,cad 

Personal history:

Appetite-normal 

Sleep -adequate 

Bowel and bladder habits - regular 

No addictions 

General examination : 

Patient is conscious, coherent and cooperative moderately built and moderately nourished .

Vitals :

Temp - 98.1 degree f 

Pr -113 BPM 

Bp -160/110 mmHg 

Spo2 -98% @ra 

GRBS - 151 mg/dl 

Systemic examination : 

CVS -S1 S2 + 

Rs - BAE + ,nvbs heard 

P/A -soft ,non tender , no organomegaly 

     Bowel sounds + 

CNS - nfnd  

  





Investigations : 













Diagnosis-? Panic attacks
K/C/O Hyperthyroidism. 
Treatment-
1.Inj pantop 40mg iv bd
2.Tab carbimazole20mg po bd
3.Syp sucralfate 10ml po tid.



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