37 year old male heart patient with gastric problem

July 06, 2022

NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT

HISTORY: The patient is a grocery shop owner. In 2012, one day he felt quite uncomfortable, with lightheadedness, and fatigued. So, he went to a local Clinician. HTN was diagnosed. He has been taking medication since then for it. In 2015, he had one episode of heart attack; he felt an uncomfortable pressure, squeezing like pain in substernal region which lasted for 1 hr approx after which it subsided on its own. 2 days prior to that he said he started suffering from constipation and was having trouble in passing stool. On the day of his heart attack, he ate a lot of curd, sweets, and chicken, since it was Sunday with his friends in lunch. After lunch, he started having substernal pain which he believed to be due to gastric issues. So, he forced vomit 2-3 times and took some antacids. Later on that day he visited a Clinician who have his medicine. 2 days later he started having hiccups that were not going away, so he visited a Clinician, who advised ECG. . He went to Siliguri and there in a hospital angiogram was done. A coronary art. block was detected. Dr. gave him medications For 2 years he was fine with the medications but due to many medications he wanted a second opinion, so went to Bangalore in 2017. Was taking the medications recommended from Bangalore. 1 -1.5 yrs ago, he gradually started suffering from persistent gastric problems (acidity, flatulence, swelling up of abdomen, sour taste in mouth) almost every day. And he used to take antacids for that almost regularly. 9 months ago, stent angioplasty was done. He started smoking at age 20 due to peer pressure and used to smoke 2-3 cigarettes/day initially, later 5-7 cigarettes/day, sometimes even 1 pack. Stopped 9 months ago, after angioplasty. He started drinking alcohol (250ml 2-3 times /wk) at the age of 27 yrs due to peer pressure. Stopped 9 months ago after angioplasty. He has HTN (under control with medication) but is non-diabetic. After stent placement, he claims to have given up mutton and very rarely eats spicy or fast-food, maybe noodles from outside 1-2 times a month. He does not drink milk tea, only red tea sometimes. Even before his heart problem was detected he did not eat spicy foods frequently.

CURRENT CHIEF PROBLEMS AND PATIENT'S REQ.: For the past 1-1.5 yr he is suffering from this gastric problem. It is more severe when he eats roti, so eats rice mostly, but still eats roti for good bowel clearance. But in spite of controlling his diet, and not eating junk food, his problem is not resolved. So, he takes tab. for the same almost regularly. He is afraid that taking antacids almost regularly is harmful, so wants a solution for his gastric issue.

FAMILY HISTORY: Father died at the age of 65. Was a cardiac patient, had 3-4 episodes of heart attack and had bypass surgery. He had a huge workload of setting up his stall in fairs. Paralyzed and bedridden for last 8-9 yrs till his death.

Mother is diabetic and HTN. Also has a gastric problem sometimes which resolves with medication.

2 elder brothers, with no health issues. one has a shop selling stationary and another one has a small eatery.