Page 59 - #Dr Shahid Merchant Biography

Cases

Management of Hypertension Emergencies
Update on Management of Cardiac emergencies
Case 8 : Patient Name - Mrs. Doris
for Family Doctors, Physicians and ICCU Staff
Systolic BP > 220, Diastolic > 120 mmHg

End organ damage Heart, Brain, Kidney, Retina

Treatment goal reduce BP by 25% in 1 to 2 hours than
Editor in Chief - Dr. S. A. Merchant
160 / 100 over next 6 – 12 hours

SL NTG, SL Captopril, IV Lasix Interventional Cardiologist
Bilateral Renal Artery Stenting
IV NTG, IV Lasix, IV Envas, IV Labetolo, IV Nitroprusside
DM (Cardiology) MD (Med), DNB (Cardiology), FSCAI (USA)
Work – up on Secondary Hypertension – Renal artery stenosis, Pheo, Coarct, Adrena / Pituitary Tumor Helpline: +91 9820930389
www.drmerchant.co.in
Mrs. Doris 62 years female patient with resistant hypertension not control on five drug combination
therapy presented with Angina , heart failure , ass CAD, Diabetics , Dyslipidemia. Serum creatinine 2.1 , Dr. S. A. Merchant is a Consultant Interventional
Oxygen Sat 92% on 10 lt oxygen mask , ECG- LBBB, Echo - dilated LV, EF 35 % , moderate MR. Cardiologist for more than 25 years at Mumbai, India.
LAD 90% long stenosis in proximal segment , RCA Ostial CTO, Bilateral critical 95% ostial renal artery
Affiliated to Lilavati, Saifee, Raheja Fortis, Umrao Hospitals.
stenosis. Treated with Bilateral stenting. Patient discharged on third day with control of heart failure, Sr.
cretinine-1.2, O2 – 99% on room air

Managemenet of DVT with Pulmonary Embolism Initial Reperfusion Treatment of Acute Myocardial Infarction
Onset of Syptoms – 12 lead ECG – Aspirin 325 mg /
Case 9 : Patient Name : Suryakant Khare
Clopidogrel 300mg / Clexan 0.6 Sc / SL NTG / Atorvastatin 80 mg
Suryakant Khare 40 Years old male
patient on computer for 8 hours
complained of acute breathlessness
and sweating. On hospital admission Call of Ambulance
in ICU he was tachypnoic with low
oxygen saturation and tachycardia,
ECG–S1Q3T3, R in V1, D–Dimer
position 2DEcho–RVVD. Pulmonary
CT showed extensive pulmonary
thrombus embolism. He was given IV Pre / Hospital Pharmaco
Pulmonary CT angio IVC Filter
Elaxim and IVC fiter was deployed to PAMI < 90 min Invasive < 24 Hour
prevent further thrombi to ambolise Thrombolysis < 30 min
from the DVT to the pulmonary
arteries. Primary Angioplasty in Myocardial Infarction (PAMI)
Case 1 : Patient Name : Gada
Critical Aortic Stenosis In Shock Treated With TAVI
(Transfemoral Aortic Valve Implant) Mrs Gada 62 year old diabetic for 20
years presented with acute chest pain,
Case 10 : Patient Name : Mumtaz Sayed she reached the hospital in 60 minutes
Mumtaz Sayed 62 years old Diabetic CABG 12 and had a ventricular fibrillation in the
years ago presented with heart failure & shock emergency room. A DC shock was given
and she was shifted to cath lab, loaded
treated medically. 3D–Echo showed critical
with Prasugrel, Femoral access taken Inj
aortic stenosis refused by surgeons for AVR.
bivaluridin given Coronary angiography
Treated with catheter based Criber Aortic valve
showed total occlusion of LAD artery in
implant sucessfully, presently walks briskly for
proximal segment which was treated by
30 minutes daily. thrombus aspiration, Intracoronary PRE Stent Deployment POST
Eptifibatide, nikorandil and vessel was
Balloon Valvuloplasty TAVI stented with Mesh Stent. (M-Guard)