28Yrs Male;Avrg.Built Sudden onset SOB ; Palpitation;Hiccups H/o Vomiting H/o Syncope once Non- Diabetic HTN 5 yrs Chain Smoker Blood Pressure Normal Pl..discuss

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Sinus tachycardia, RAD,st elevation in Inferior leads and St segment depression in lead 1 and AVL, RBBB pattern,st segment elevation in v2to v4.suggestive of anter Wall mi with Inferior Wall involvement.fragmented qrs in Inferior leads, prolonged pr intervel suggestive of first degree av block.

thanks Dr Prashant metri
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Ecg suggestive of Acute AWMI Needs reperfusion therapy Now there are also features suggestive of Trifasicular block RBBB with LPHB with PR prolonged I think there changes are separate , and in view of old syncope needs careful attention May needs Holter, HV interval study on EPS but I personally feel if changes persist after treating MI and history was highly specific for cardiac syncope, needs pacing also apart from CAG and PCI

It's a case of anteroseptal myocardial infarction with right bundle branch block.

STEMI ANTERIOR WALL & INFERIOR WALL SINUS TACHYCARDIA RT AXIS DEVIATION BLOOD = CREATININE SUGAR TROP I O2 SATURATION RX O2 INHALATION IF SATURATION IS BELOW 94 % CAG PCI

Acute antero-septal and inferior wall MI with st elevations seen in bipolar leads II and III, augmented lead aVf, chest leads V2 to V4 with incomplete RBBB, with history of smoking and htn in this young patient. Treatment involves thrombolysis with STK or UFHeparin 5000U bolus followed by infusion @ 1000U/hr, aspirin 325mg stat then 150mg daily, clopitab 300mg stat then 150mg once daily, sorbitrate 10mg tid, ranolazine 500mg bid, atorvastatin 40mg hs, ivabradine 5mg bid, betablockers if no previous h/o copd, avoidance of smoking. CAG and 2DEcho to plan for PCI. Lipid profile needs to be checked

Anterior wall MI

Its Q Rbbb with Anterior wall MI...Its Wrap around LAD or Non Proximal LAD occlusion

Dr sandeep ur are very wright in saying that ecg favours mid LAD disease in a type 3 LAD but don't think it's qrbbb it's just old RBBB Which is not related to present MI qrbbb is a feature of proximal LAD
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Anterioinferior mi Wraparound lad

old inferior wall MI with acute anterior wall MI

Anteroseptal And Inferior MI with RBBB with first degree heart block

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Diseases Related to Discussion

Copd
Anteroseptal Myocardial Infarction
Right Bundle Branch Block