Fact to know?
found fainted, chest pain & shortness of breath when climbing stairs
heart rate 100 per minute, BP was 180/100, He needs to eat frequently but always in small amount, otherwise, he is likely to feel dizzy
. difficult to bowel opening.
What disease(s) he might have got?
LOC(lost of consciousness)
hypertension (problem)
?hypoglycemia due to DM
?constipation
?angina (?CHF ?ACS)
Justify your answers.
'found fainted': LOC.
BP on high side : poor BP control.
HT, SOB and mildly elevated HR: ? due to climbing stairs, but in this case it associated with chest pain: ?poor cardiac perfusion, ? heart disease.
patient need to needs to eat frequently but always in small amount otherwise he is likely to feel dizzy: dizziness associated with unstable blood sugar level, ? DM with poor DM control.
difficult to bowel opening: constipation.
if feel chest pain when BO, heart problem would be the most concern.
as LOC may be due to HT/heart problem or hypoglycemia in this case, further assessment should be done on this two problem.
In long term, apart from taking medicine, what recommendations you should give him?
for HT: check BP regularly, look out sign & symptom of hypertension (headache, blur vision) or hypotension (dizziness, postural hypotension) if on anti hypertension drug
for chest pain and SOB when exercising: decrease exercise level, rest if chest pain or SOB, education on TNG and puff if needed, and he should go to see doctor if chest pain or SOB no subside after rest.
for ?poor DM control: look out sign & symptom of hypoglycemia (dizziness, feel hungry, sweating) and management (sugar cube or candy), regular H'stix for blood sugar monitoring (especially those patient on insulin), DM drug and diet education.
for constipation: increase fiber intake by vegetable and fruit, drink adequate water, regular time to go to toilet.
for history of LOC: look up for history of seizure, and take anti convulsion medication in time, if any.