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Hyspnoeic Case Studies

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PHYSICAL EXAMINATION: Mr P is alert, orientated and responds appropriately to questions. He is clean shave with low hair cut. He is Height 183cm weight 88kg, Body Mass Index (BMI) 26.3, which shows that he is overweight. He appears to be anxious and in moderate to severe distress, his hands are moist and cold. His colour is good; he lies flat with moderate chest discomfort. Vital signs: Blood pressure (BP) Right hand 167/95, left hand 170/98, and no significant difference in BP of both arms. Cardiac arrhythmias noted, heart rate (HR) 106 beat per minute; heart rhythm was irregularly irregular, but no evidence of blood loss or internal bleeding, radial pulses was strong bilaterally. Mr P was dyspnoeic, mild to moderate increased work of breath noted, respiratory rate (RR) was 28 but no hypoxia, oxygen saturation by finger probe was 96 % on room air. Therefore there was no need for supplementary oxygenation. Oxygenation is recommended to maintain saturation of oxygen above 90% in suspected ACS. No sign and symptoms of infection or sepsis, he was a febrile, temperature was 37.4 degree centigrade. No diabetes ketoacidosis (DKA), blood sugar level (BSL) 8.6 mmols was within acceptable limit. DKA is a contributing factor to nausea and vomiting in diabetic patient with acute myocardial infarction (MI). Skin: Warm, wet and sweaty (diaphoresis) but good colour. Diaphoresis is a common occurrence in patient with acute MI. No lesion, no nail clubbing and no cyanosis. Head, Eyes,

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