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Keep off your cell phonesilent please!

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WEEKLY DEATH PROFILE 0F CARDIOLOGYDEPARTMENT,NICVD.

FROM 06-11-12 TO 12-11-12

Presenter:

Dr. Asif Zaman TusharMD Cardiology, 3rd part student

NICVD

Moderator

Dr. Nupur kar

Assistant Professor of Cardiology

NICVD

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Comparison between total admission & death

7%

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Age and sex distribution of expired patients:

Age No. of expired patients

60yrs 18

Total: 53Male : 36

Female : 17

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Primary causes of death:IHD:

STEMI : 15UA : 07NSTEMI : 05

Cardiomyopathy : 12Valvular heart disease : 04Congenital Heart disease : 03Arrhythmia : 7

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Secondary causes contributing to death

Cardiogenic shock : 18Acute LVF : 20Complete heart block : 8Electrolyte imbalance : 4Others : 3

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Risk factors for IHD Co-morbidconditionsSmoking 17 COPD /

Br. Asthma12

HTN 22 CKD 5DM 14 CVD 2Dyslipidemias 12Positive family history ofIHD

10 ARF 2

Risk factors & Co-morbid conditions

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Discussion of death of selected patientParticulars of the patient:

Name : Sattya pal

Age : 65 years

Sex : Male

Address : Muradnagar , Comilla.

Date and time of adm. : 06.11.12, 01:55 am

Date and time of death: 06.11.12, 04:10 am

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CHIEF COMPLAINTS :Chest pain for 10 hrs.

HISTORY OF PRESENT ILLNESS:According to the patient, he was reasonably well 10 hrs back.

Since then he developed compressive chest pain which radiates

towards left arm associated with vomiting and sweating .Patient was normotensive and nondiabetic.

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H/O past illness :Nothing contributory

Family history:Nothing contributory.

Personal history:Non- Smoker

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Clinical examination : (on admission)GENERAL EXAMINATIONS:Anxious

ANAEMIA - absent

JAUNDICE- nil

OEDEMA- nil

PULSE- 92/MIN, regular

BP 100/70 mmhg

JVP - not raised.

Respiratory rate: 20/min

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Clinical examinationcontinued

Cardio Respiratory system :HEART: Normal.LUNGS : Vesicular breath sound.

OTHER SYSTEM: Revealed no abnormality

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DIAGNOSIS ON ADMISSION

Acute MI Inferior with

posterior extension

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TREATMENT on admissionBed restO2 Inhalation: 4 lit/minTab. Aspirin 300mgTab. Clopidogrel 300mgTab. Atorvastatin 20mgInj. StreptpkinaseInj. MorphineInj. Prochlorperazine

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Treatment and follow up

Follow up at 3:00 am on 6.11.12

P/C- breathlessness

O/E

Pulse-112/min

BP- 85/60 mm of Hg

R/R- 26/minheart- soft S1/ S2.

Lungs- fine bilateral basal crepitation.

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Rx given

Inj. Frusemide Inj. Dopamine - 5ml/hr

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Treatment and follow up

Follow up at 3:30 am on 6.11.12

Pt developed cardiac arrest.

CPR started immediately and endotracheal intubation was done. All

other necessary medications were given. CPR continued for 30

minutes but patient did not revert back. Patient was declared dead at

4:00 am.

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PRIMARY CAUSE OF DEATH:

AMI Inferior with posterior extension

SECONDARY CAUSE OF DEATH:

Acute LVF

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WHAT COULD BE DONE IABP

PCI .

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