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WEEKLY DEATH PROFILE 0F CARDIOLOGY DEPARTMENT,NICVD. FROM 06-11-12 TO 12-11-12

Presenter:

Dr. Asif Zaman Tushar MD Cardiology, 3rd part student NICVD

Moderator

Dr. Nupur kar Assistant Professor of Cardiology NICVD

Date

Unit

Male

Female

Total

Ped-1

Ped-2

Grand Total

Death

06.11.12 07.11.12
08.11.12 09.11.12 10.11.12 11.11.12 12.11.12

2 3
4 5 6 7 8

62 79
81 69 75 94 85 5

22 46
39 19 33 33 39 2

84 125
119 88 108 127 124 --

0 2
0 0 0 0 0 --

4 0
3 1 2 4 0 --

88 127
122 89 110 131 124 --

6 5
7 8 7 6 7 7

Non admission unit

TOTAL

544

231

775

14

791

53

Comparison between total admission & death 7%

Age and sex distribution of expired patients:

Age <20 yrs 20-40yrs 40-60yrs >60yrs Total: 53 Male : 36 Female : 17 No. of expired patients 03 06 26 18

Primary causes of death:

IHD: STEMI UA NSTEMI Cardiomyopathy Valvular heart disease Congenital Heart disease Arrhythmia : 15 : 07 : 05 : 12 : 04 : 03 : 7

Secondary causes contributing to death

Cardiogenic shock
Acute LVF

: 18
: 20

Complete heart block

Electrolyte imbalance

: 8
: 4

Others

: 3

Risk factors & Co-morbid conditions

Risk factors for IHD
Smoking 17

Co-morbid conditions
COPD / Br. Asthma CKD CVD 12

HTN DM

22 14

5 2

Dyslipidemias
Positive family history of IHD

12
10
ARF

Discussion of death of selected patient

Particulars of the patient:

Name Age Sex Address

: Sattya pal : 65 years : Male : Muradnagar , Comilla.

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

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

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.

H/O past illness : Nothing contributory Family history:

Nothing contributory.

Personal history: Non- Smoker

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

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

OTHER SYSTEM: Revealed no abnormality

DIAGNOSIS ON ADMISSION

Acute MI Inferior with posterior extension

TREATMENT on admission
Bed rest O2 Inhalation: 4 lit/min Tab. Aspirin 300mg Tab. Clopidogrel 300mg

Tab. Atorvastatin 20mg

Inj. Streptpkinase Inj. Morphine

Inj. Prochlorperazine

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/min heart- soft S1/ S2. Lungs- fine bilateral basal crepitation.

Rx given
Inj. Frusemide Inj. Dopamine - 5ml/hr

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.

 PRIMARY CAUSE OF DEATH:

AMI Inferior with posterior extension

SECONDARY CAUSE OF DEATH:

Acute LVF

WHAT COULD BE DONE

IABP
PCI .