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

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Anterior & inferior wall infarction with LVH.

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p pulmonale rad with rvh with strain

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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.

pt has no chest pain Dr. jairam patil sir. .

atypical presentation can be there. Chest pain is not always required to diagnose ACS sir. dyspnoea can be angina equivalent . high lateral wall showing deep q waves. may be old or evolved MI which has caused anasarca. tall R waves in precordial leads with ST depression ( not horizontal but still significant ). do echo , cardiac enzymes. history is not revealing any other cause for anasarca. is the patient alcoholic with liver cirrhosis sir. any other clinical findings pls inform sir.
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double wall MI inferoanterior with atropic CHB

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right bundle branch block right axis deviation rv strain pattern p pulmonale all are suggestive of cor pulmonale pt was c/o dyspnea so rule out copd or pulmonary embolism

Thank you so much for ur answer's
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pulmonary artery hypertension

nstemi inferior wall mi

Lateral wall stemi with post wall mi and reciprocal changes in inferior leads. Adv Echocardiography. Cardiac enzymes and other investigations for anasarca.

chronic smoker. .and he has congenital heart disease also

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