Orris
attachment
attachment

What is treatment

analyse_media
Based on the emergency card, this patient (Dayanidhi Takri, 45M) presents with:
  • Chief Complaint: Head reeling (dizziness/vertigo) for 12 hours
  • Known case of: Hypertension (HTN), already on antihypertensive medications
  • BP on arrival: 150/100 mmHg (elevated), PR 78 bpm, SpO2 100%
This is a case of hypertensive patient with dizziness - likely a hypertensive urgency or vertigo in the context of uncontrolled hypertension.

Recommended Treatment Approach

1. Immediate Management (Casualty)

  • Check if BP medications were taken today - patient says they are on HTN meds
  • Re-check BP after 15-30 minutes of rest in a quiet room
  • 12-lead ECG - rule out cardiac cause
  • Blood glucose - rule out hypoglycemia as cause of dizziness

2. For Hypertension (BP 150/100)

This is Grade 2 hypertension - no hypertensive emergency (no end-organ damage signs noted). Management:
  • Review and optimize current antihypertensive regimen (the exact drugs are not listed on this card)
  • Oral antihypertensives - do NOT give IV or fast-acting agents unless BP is >180/120 with symptoms of end-organ damage
  • Common oral options: Amlodipine 5-10 mg, or Telmisartan 40-80 mg, or a combination
  • Do NOT rapidly lower BP - can worsen cerebral perfusion and worsen dizziness

3. For Dizziness/Head Reeling (likely vestibular/hypertension-related)

  • Tab. Betahistine 16 mg twice or thrice daily - for vestibular vertigo
  • Tab. Stemetil (Prochlorperazine) 5 mg - for nausea/dizziness relief
  • Avoid head movements - advise patient to rest

4. Investigations to Order

  • CBC (anemia can cause dizziness)
  • RFT (renal function - important in HTN)
  • Serum electrolytes
  • ECG
  • Blood sugar (fasting/random)
  • Urine routine

5. Referral

  • Medicine OPD follow-up for optimization of antihypertensive therapy
  • If dizziness persists or new neurological signs appear (slurred speech, facial deviation, weakness) - urgent CT brain to rule out stroke
Key point: The patient's dizziness is most likely related to either poorly controlled hypertension or benign vestibular disorder. Since BP is 150/100 (not severely elevated) and SpO2 is 100%, this is not a hypertensive emergency - manage with oral medications and symptomatic relief, and ensure proper follow-up.
Note: This is general clinical guidance only. The treating doctor at the casualty should make all final treatment decisions based on full examination findings.
This is a shared conversation. Sign in to Orris to start your own chat.