20 yrs Female came to ER with Chief complain of Bloody vomiting ! 2 episodes. On routine ECG examination ST segment depression was found in III only ! After testing for cardiac bio markers..CK -MB was 38 and Trop I was positive. After 12 hrs of admission markers were re-evaluated ..and CK -MB was 42 and Trop I was positive. Patient went on LAMA. After 2 days pt came with same chief complain of bloody vomiting. On ECG now there was T wave inversion on III. But cardiac markers were negative. There is no h/o of SOB, chest pain,headache diaphoresis or weakness of body . She has not passed stool for 5 days She wieghs 83 kg and looks like 30 yrs ( She's 20 yrs) What is the diagnosis? Treatment modalities ?
rule out gastric causes such mallery waise, ulcer, esophageal varicus, check for mitral reg, liver function and portal hypertension, ECG findings
USG was done-no signs of portal hypertension..Normal LFT..Normal ECHO..and Endoscopy couldnot be done due to positive bio markers!
Her BP is normal..IO has been ruled out..Stool OBT is negative..and guess what..Cardiac biomarkers are Significant again..CK-MB 42 ..and Trop I positive! No suggestive clinical features
Mitral stenosis...?RVH leads to ischemia and elevated cardiac markers....
No LV hypertrophy as ECHO ruled it out ! No any known CNS disorder..On Nervous System Examination -It appears Normal
Eosinophil count was normal ! Nice guess .Bt it only explains bloody vomiting! Not increased enzyme !
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