42 yrs old male pt admitted with complaints of breathlessness and anasarca. .. 1. ecg findings? 2. differential diagnosis?

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final diagnosis is COPD..PHT.ASD OS TYPE. simultaneous t wave inversion in infr and anterior leads. ..always suspect PHT..not ischemia. .In acute setting more specific for pulmonary embolism. . Thank you for all the participants

R>Sin V1 and RAD= RVH P pulmonale Means PAH Commonest cause COPD causing cor pulmonale. Other causes include ASD, primary pulmonary hypertension, pulmonary stenosis, pulmonary embolism etc

Narrow complex tachycardia. P pulmonale. Q wave in 1 and aVL Right axis deviation. Inverted T wave in II, III, aVF, V1-5 Old case of anterio wall MI with infero lateral wall sub endocardial infarction. D/d electrolyte imbalance Beta agonist inhalation Hypothyroidism

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Anterior & inferior wall infarction with LVH.

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Evolving anterior wall infarction. Q wave with st coving up in 1 avl.reciprocal t inversion 11 111 avf v1 to v5.sinus tachycardia. Must be in cardiac failure. Pl get his 2d echo He must be having severe lv dysfunction Both systolic & diastolic may be MR also

ecg S/o sinus rhythm Right axis RVH with Strain pattern (Deep S in 1, Avl, v5,v6 and St depression with T inversions in Inferior leads and right precordial leads) Right Atrial enlargement (p pulmonale) ecg consistent with Right Heart dominance 1.VSD with Eisenmengerisation 2.Conditions associated with pulmonary valve Stenosis

Posterolateral MI...ST elevation in V6 and reciprocal ST depression from leads V1 to V3 with tall R waves in V1 V2..suggestive of Posterior wall MI..also ST elevation in lead I and avL with reciprocal ST depression in leads II ,III and aVF suggestive of high Lateral MI..most probably Posterolateral MI..

also q waves in Leads I and aVL..
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sob anasrca a long list of multifactorial multiorgan end stage DISEASE . Cardiac CCF lt and rt v failure with this ECG it seems to rt v failure pulmonary HT.

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Evolved Lateral wall STEMI with posterior wall MI. reciprocal changes in inferior leads. patient is in LV failure. Lesion most probably in D1 or Prox LCX or RCA ( post wall MI may have either RCA or LCX but more likely to be LCX here). do echo , cardiac enzymes & other routine investigations. Actually acute LVF is unlikely to cause generalised anasarca. may be a known case of CCF. treat like ACS with anticoagulants, dual anti platelets,stations,diuretics,ACE inhibitors &/or ARBs . patient is young so early CAG followed by PTCA.

rad,rvh,p pulmonal. possibilities chronic lung disease,rt heart failure,with ?rhd ??congenital heart disease

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