Thursday, July 6, 2017

Best Cardiologist in Rudrapur

Dr. Jitesh Arora
MD, Physician, Dip Cardiology
Consultant Cardiologist and Diabetologist

Clinic Address 

Arora Heart Care Center
28/1, D1 D2, Civil Lines Rudrapur

Contact - 9639355527, 9837544401
email - drjitesharora@gmail.com

Facilities 

ECG 
ECHO
TMT
Cardiac Consultations
Comprehensive Diabetes Management
Health Packages



Heart attacks don’t always cause chest pain. Here’s what you require to know and do to protect yourself in a crisis.

While sharp chest discomfort, or sensation of pressure or tightness in the chest, may be the typical signs of heart attack, if you’re a woman or have diabetes, you’re less likely than others to feel these signs. In fact, one-third of all people with heart attacks report no chest pain at all. If you’re diabetic, follow these two steps for safety:

1. Learn atypical heart attack signs

  • Shortness of breath
  • Nausea or vomiting
  • Profuse sweating
  • Palpitations and tremors
  • lightheadedness or Dizziness


Sudden pain in other areas of the upper body, such as the spine, upper limbs, neckline, jaw or abdomen, may also imply a heart attack.

2. Take action if you have heart attack signs


Call emergency services if you have chest discomfort or atypical symptoms that last more than 10 minutes. Chew and swallow a noncoated adult aspirin. It promotes the dissolution of blood clot—chewing or crushing the tablet allows it to enter your bloodstream quicker. Open the front door if you can, while you wait for the ambulance. Sit or rest on the floor nearby to make it accessible for the paramedics to get to you. If calling emergency services isn't possible, have somebody drive you to the nearest hospital—never drive yourself unless you have absolutely no other option.

              

Angina or Heart Attack?


If you have been diagnosed with angina—a narrowing of one or more coronary vessels that diminishes blood flow to the heart—you may feel pressure below the breastbone or chest pain that exacerbates predictably with activity. Note that some people have atypical signs with angina. Take emergency measures if chest discomfort occurs at rest and lasts for more than 20 minutes, progress in severity, or occurs with less effort than in the past.

If you are looking for Online Cardiology Consultant then I would recommend you to visit https://drjitesh.com/online-consult/



Thursday, June 29, 2017

Dr Jitesh Arora MD, Dip Card - Consultant Cardiologist and Diabetologist

Dr. Jitesh Arora - M.D. Physician, Dip Cardiology / Consultant Cardiologist /Chairman: Arora Heart Care Center 

Dr. Jitesh Arora is a practicing Non-Invasive cardiologist by profession having over more than 10 years of experience.

Born in India in 1983, followed by education in India and Ukraine, he is now residing in Uttrakhand India.

Dr. Arora completed MD  from Ternopil State Medical University, India. He completed his Internship in Internal Medicine at Safdarjung hospital and Vardhman Medical College, New Delhi. After completing his internship he joined post-graduate Diploma in Clinical Cardiology at Artemis Health Institute Gurgaon. 

Dr. Jitesh started practicing Clinical Cardiology and Echocardiography from 2013 onwards.Currently, he is running his own hospital, Arora Heart care center situated in Rudrapur, Uttrakhand. 

Dr. Jitesh Arora is available for Online Cardiology Consultation at http://www.drjitesh.com




Thursday, April 24, 2014

Cardiology Case Scenario - Mitral Stenosis

30 years old male came to the ER with c/o palpitations and sweating since last 30 minutes.
Heart Rate – 220/min
B.P 120/80 mmHg
ECG shows AVNRT

2D Echo reveals that Patient is a case of Isolated Mitral Stenosis 
















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Thursday, November 8, 2012

Cardiology Case Scenario- Make your Diagnosis

A 60 year old gentleman with  history of hypertension and diabetes mellitus presents to the emergency room with retrosternal chest pain . He is afebrile, blood pressure is 110/70 mmHg, heart rate 70/min, and respiratory rate 18/min. Physical examination reveals normal lung sounds, normal jugular venous pressure, and an S4 heart sound. Laboratory studuies are initially normal. His ECG is below. What complication is most commonly associated with this patient's diagnosis?
















 A) Acute mitral regurgitation
 B) Left ventricular thrombus
 C) Left ventricular aneurysm
 D) Left ventricular Free Wall rupture




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Sunday, November 4, 2012

19 year old boy Passes out while running- Next Step in Management ?

A 19 year old boy with no past medical history passes out while running at a school evnt. He states that he was feeling a little dizzy prior to the event, but does not complains of chest pain or palpitations. His blood pressure is 120/85, heart rate 85/min, Respiratory Rate 12/min, and he is afebrile. His physical examination reveals normal lung sounds, a II/VI mid-sytolic creshendo-decreshndo murmur is heard at the right upper sternal border which increases in intensity with Valsalva, an S4 heart sound is also present. Laboratory studies are normal. What is the most appropriate treatment at this time?


 A) Start a Diuretic
 B) Permanent Pacemaker Implantation
 C) AICD Implantation
 D) Observation
 
 E) Start  Beta Blocker


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Monday, October 29, 2012

89 year old gentleman with history of Syncope - What should be the next step in management ?

A 89 years old gentleman with a history of hypertension and osteoarthritis presents to the ED with an episode of syncope while listening to music. He has felt generally lethargic for the past one week. He denies  chest pain, shortness of breath, or fever. His medications include Metoprolol and celecoxib. The blood pressure is 120/60 mmHg, H/R 42/min, R/R 15/min, and he is afebrile. His physical examination reveals normal lung sounds, a regular, bradycardic rhythm with varying intensities of the S1 heart sound on auscultation, and intermittent large cannon A waves in the jugular venous pulsation. His laboratory studies are normal. The ECG of the patient is depicted below. What is the next step in management of this patient?













 A) Observation

 B) Stop Metoprolol
 C) Permanent pacemaker implantation
 D) AICD Implantation

Answer-
Diagnosis -2nd degree AV block - high grade - Mobitz II 
Next Step in Management - Stop Metprolol and be ready for PPI 
Thanks to all for contribution

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Saturday, October 27, 2012

A 62 year old gentleman found unresponsive - What should be the Best Course of Action?

A 62 year old gentleman with a history of diabetes mellitus, hypertension, and a renal transplant presents to the ED after being found unresponsive at office. His temperature is 37.6 C, blood pressure is 80/30, heart rate 130, respirations 25, and oxygen saturation 75% on room air. Physical examination reveals bilateral pulmonary rales, a S4 heart sound is present, and no murmurs could be auscultated. He is intubated for airway protection. ECG reveals sinus tachycardia with a LBBB. 



A Swan-Ganz catheter is inserted and the values are below:

Right atrial presssure - 8 mmHg
Right ventricular pressure - 38/8 mmHg
Pulmonary artery pressure - 42/22 mmHg
Pulmonary capillary wedge pressure - 26 mmHg
Cardiac output - 4.0 L/min
Cardiac index - 2.0 L/min/BSA

Which of the following is best course of action?


 A) Emergency Echocardiography
 B) Emergent cardiac catheterization
 C) Tissue plasminogen activator infusion (tPA)
 D) Glycoprotein IIb/IIIa infusion


Answer: B - Emergent Cardiac Catheterization

The patient depicted in the question presents with severe shock. His Swan-Ganz pressure readings shows low cardiac output and elevated PCWP which reflects cardiogenic shock.Late stage septic shock can actually appear similar when the heart begins to fail, however the presentation is more acute in case of septic shock. This patient is most likely having a large myocardial infarction causing left ventricular dysfunction and reduced cardiac output leading to hypotension. He must be taken emergently for cardiac catheterization to revascularize the culprit coronary artery. Cardiac catheterization with stenting has been shown to be superior to thrombolytics in patients with cardiogenic shock. Inotropes could sometimes be helpful to stimulate inotropy and cardiac output, however this can worsen ongoing myocardial ischemia as well. 

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Cardiology Case Scenario - Make Your Diagnosis


A 68-year-old gentleman is admitted with an Anterior myocardial infarction (MI) and receives thrombolysis, aspirin, atenolol, atorvastatin and lisinopril. His ECG shows good ST segment resolution.
The next day he develops some pain in the legs and a dusky discolouration of the lower limbs. On closer examination there is a diffuse petechial rash over the lower limbs, particularly the feet, but all peripheral pulses are palpable.

Investigations reveal:

Haemoglobin13.3 g/dl(12-16)
Platelets145 ×109/l(150-400)
White cell count12.1 ×109/l(4-11)
Neutrophils6.5 ×109/l(1.5-7)
Lymphocytes3.5 ×109/l(1.5-4)
Eosinophils1.2 ×109/l(0.04-0.4)
IgE antibody3 kU/l(<2 br="br">


Which of the following is the most likely cause for his current situation?
  1. Polyarteritis Nodosa
  2. Aspirin Allergy
  3. Periphral Vascular Disease
  4. Cholesterol Emboli
  5. Post Thrombolysis Allergy

Answer

The  above patient is an arteriopath as suggested by the acute Myocardial Infarction, and one day after thrombolysis he develops a petechial rash in the lower limbs with raised white cell count - marked eosinophilia and raised IgE. This suggests cholesterol embolisation syndrome rather than allergy. 



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Thursday, October 25, 2012

Cardiology Case Scenario with ECG -Make Diagnosis


An 75-year-old female presented with community acquired Pneumonia. She has been successfully treated with Erythromycin and nebulised salbutamol. She has taken furosemide 40 mg/day and digoxin 0.25 mg /day for a number of years.
she developed a brief episode of chest pain in the ward. An electrocardiogram was taken.


Make your Diagnosis....

You can leave your answers in the Box Below







Answer

The diagnosis is Second Degree AV block


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Wednesday, October 24, 2012

Cardiology MCQs - Choose the Appropriate Beta Blocker

  • A 50 year old gentleman with severe asthma is having a Acute Myocardial Infarction. Which of the following beta-blockers can potentially treat his MI while causing minimal Bronchoconstriction?


  •         Metoprolol

            Propranolol

            Carvedilol

                                                                   Nadolol








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    Tuesday, October 23, 2012

    All You need to Know About Digoxin







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    MCQ - Choose the Culprit Drug




  • A 60 year old male with a history of congestive heart failure and atrial fibrillation states his vision has been mostly yellow recently. He has noted lack of appetite and weight loss. Laboratory studies reveal and elevated potassium level. Which of the following is the likely causing his symptoms?
  • Nitroglycerine
    Digoxin
    Amiodarone
    Spironolactone
    Sildenafil




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    Saturday, October 20, 2012

    Cardiology MCQ- Cause of Sudden Cardiac Death




  • A 19 year old girl is noted to have a reduced upper to lower body segment ratio, positive Walker and Steinberg signs, and pectus carinatum. Her father died suddenly at the age of 32. She is subsequently diagnosed with Marfan’s syndrome. Which of the following was the likely cause of death of her father?


  • Congestive heart failure

    Aortic dissection

    Myocardial infarction

    Aortic valve regurgitation

    Mitral valve prolapse

    Click The appropriate Option




    Echocardiography- Massive Pericardial Effusion



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    Friday, October 19, 2012

    Cardiology MCQ - Make your Diagnosis

    A 72 year old female with a history of breast cancer and tobacco use complains of dizziness and dyspnea on exertion. Her heart sounds are distant and her systolic blood pressure is noted to markedly decrease with inspiration. Which of the following is the most likely diagnosis?


    A) Constrictive cardiomyopathy
    B) Mitral valve Stenosis
    C) Congestive heart failure
    D) Pulmonary embolus
    E) Cardiac Tamponade

    Answer    E
                     Cancer is the most common cause of pericardial effusion and when enough fluid accumulates in the pericardial space, cardiac tamponade occurs. “Pulsus paradoxus” is when there is a decrease in systolic blood pressure during inspiration due to failure of the right ventricle to accept the normal increased venous return that occurs with inspiration. This also results in a “Kussmal’s sign” or elevated jugular venous distension during inspiration (normally the opposite occurs). Treatment is with emergent pericardiocentesis.

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    Friday, August 10, 2012

    Cardiology Case Scenario 1



    Click one of the Options to Choose your Answer 



    A 68 year old male with history of Hypertension, Diabetes and Urinary retention awoke feeling nauseated and light headed. He did not respond to questions from his wife. When the emergency medical technicians arrived, his blood pressure was 60 mmHg by palpation. IV fluids and oxygen were administered. Vital signs obtained in the ER were blood pressure 60 mmHg, heart rate 120 (regular), temp 39 degree celsius and respiratory rate 30/min. A brief physical examination revealed coarse rales approximately halfway up in the chest bilaterally and inaudible heart sounds. An indwelling urinary catheter was placed with drainage of 10-20 ml of dark urine. Chest X-ray revealed bilateral interstitial infiltrates. ECG was unremarkable except for sinus tachycardia. Antibiotics were administered and patient was transferred to the ICU where right heart catheterization was performed. Pulmonary capillary wedge pressure was 28 mmHg. Cardiac output was 1.9 L/min. Right atrial mean pressure was 10 mmHg. The most likely cause for this man`s hypertension was...



    left ventricular Dysfunction

    Right ventricular Infarction

    Gram Negative Sepsis

    Gastrointestinal Bleeding

    Pulmonary Emboli




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    Tuesday, July 31, 2012

    ECG Interpretation Case 5

    A 51 year old male came to the ED with ongoing chest pain  since 4 hours.
    There is no past medical history.
    No history of Smoking and alcohol intake.
    Vitals
    B.P 130/70 mmHg
    H.R 90/min
    The ECG is displayed below.
    Interpret the ECG and leave your comments in the box below.

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    Friday, July 27, 2012

    ECG Interpretation Case 4

    A 65 years old male came to the ED with complain of  retrosternal chest pain and breathlessness. Patient is known diabetic since 15 years. His ECG is displayed below.
    O/E
    B.P - 80/60 mmHg
    H.R - 50/min

    What Should be the next step in the management of this patient?





    Hello Readers, Thanks for your valuable comments. I am publishing the best Interpretation Given by  Ken Grauer, MD  of ECG Interpretation . 


    Interesting 12-lead tracing (though a bit difficult to make out given suboptimal quality). Nevertheless - there is sinus bradycardia at ~50/minute with 1st degree AV block and complete LBBB. In addition - there is definite inferior ST elevatation (lead III > II) - with reciprocal ST depression in aVL. In addition - there are primary ST changes in V4,V5,V6 - all suggesting a proximal RCA lesion in a patient with a left-dominant circulation - so urgent PCI in this hypotensive patient large evolving acute MI. Pacing may soon be needed (complete LBBB plus 1st degree). VERY INTERESTING tracing - THANKS for posting!

    For anyone interested in a user-friendly guide for determining what is the likely culprit artery (as well as likely conduction defects from various MIs) - GO TO: https://www.kg-ekgpress.com/ecg_-_coronary_anatomy-mi_localization/

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    Thursday, July 19, 2012

    Which of the following will be the most appropriate initial therapy?

    Quiz


    Click one of the options to choose your answer 


    A 50 year old gentleman is admitted to the CCU with an acute Inferior wall infarction. Three hours after the admission his B.P is 90/50 mmHg. The heart rate is 38 beats per minute with sinus rhythm. Which of the following will be the most appropriate initial therapy?

    Immediate insertion of temporary pacemaker
    Intravenous administration of of Isoproterenol 5 micrograms/min
    Intravenous administration of Dobutamine 0.35 mg/min
    Administration of Intravenous Normal saline, 300 ml over 15 mins
    Intravenous administration of atropine sulfate , 0.6 mg



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