Today actually we will learn what i have learnt in the medicine university. We had pbl recently and i would like to share what i have learnt and this is the case that was given to me last week.
Mr Sivam a 54 year old accounts clerk presented to the emergency department of UMMC with the complaint of chest discomfort for three hours. He gave history of progressively worsenig exertional dyspnoea for the past six month, which was initially mild and occuring after climbing a flight of stairs. For the past three days he felt dysnoeic even at rest. He had, on couple of nights, woken up at about 2.a.m. with a choking sensation which was relieved only after getting up out of bed and standing for a while. He also gave history of palpitation for the past six months, regular in nature but not always associated with the exercise.
He had undergone medical check up conducted at his office about five years ago, whe he was informed that his blood pressure was 140/90 mm Hg. He had been advised to undergo further tests and treatment, but had ignored it since had no health complaints. Besides, being a widower with his only daughter still in college, he did not want to add the financial burden to his family. However following the advice of the medical officer at that time he had cut down on smoking ciggarettes from 20 per day to about 10 and also reduced salt intake in his diet.
So the questions are.
1.What is dyspnoea? What dyspnoea lead for?
2.If you got chest discomfort what would the first thing that come out from your mind? What problem do you think?
3.What is the normal blood pressure in human? Is there any difference between young handsome man and old man?
All the answers that you might know you can leave it on comment below. There are two other triggers in this case and i will post it soon.
Happy answering my questions! 
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