long distance pt with chest pain

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Case History and Clinical Findings chest pain since 1 monthA/w palpitations and sweatingNot a/w SOB, vomitingPatient was apparently normal 1 month ago when he developedChest pain since 1 month -radiating to right,aggrevated on exertion.A/w palpitations went to hospital 1 month back with similar complaints associated with sweating for which he was given medicationsH/o similar complaints on and off since 1 month for which he is continuing medication HISTORY PAST ILLNESS:NOT A K/C/O DM, HTN, CAD.

GENERAL EXAMINATION PATIENT WAS CONSIOUS, COHERENT , COOPERATIVE. NO SIGNS OF PALLOR, ICTERUS, CLUBBING, KOILONYCHIA, LYMPHADENOPATHY. 

VITALS: 

BP- 120/80 

PR- 78 BPM 

RR- 22cpm

CVS- S1 S2 + 

P/A- SOFT AND non TENDER

CNS- NAD I

nvestigation 2DECHO, HAEMOGRAM,RFT, CUE 

2d echo findings

rvsp= 35 mmhg 

trivial TR + no MR/AR 

Fair LV function + no RWMA,NO MS/AS/PAH/PE diastolic dysfunction +

Treatment given

1)Fluid restriction <1.5 L/day and salt restriction <2 g/day

2) T.CARDACE METO 2.5/12.5. H/S. X--x--1

3) T.PAN 40 MG/OD 1----x------x

4) T.ECOSPIRAN GOLD 20 Po. OD X-----X--1

5)T.ALPRAZOLAM 0.25mg. H/S X-----X-----1

6)T.NITROCONTIN. 2.6 /BD 1------X-----1

7) METFORMIN. 500MG. PO/BD 1------X----1