60/F k/c/0 HTN, not taken med for last 2days presented with convulsion,drowsiness.. Bp 240/110mmhg.. Intubated on ventilator..GCS- 8/15.. Ct shows IC bleed putaminal with midline shift with cerebral oedema.. Respi.. Left side crepts.. Pt had vomited n aspirated..no air entry on left side.. ECG sinus tachy.. TLC 30000.. After 24 hrs in ICU..patient had cardiac event.. inferior MI.. Echo..
RA,RV dilated..lvef 50..rvef TAPSE 0.5cm.. Rv velocity 0.4.. Approx RVEF 10_20%.. Xrays left pneumonitis.. Pt. On inotropes.. Kft, lft normal.. Ct next day increasing shift.. Med on- mannitol,lasix, meropenam, metro, nebulization, inotropes, dexa.. How to proceed??
