45 y male Driver by profession C/o breathlessness since last two hours No comorbidities Morbidly obese Spo2-80 RA Rest normal Discuss d/D and advice further management ....

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CXR. Bi.la LZ consolidation pneumonic. Cardiomegaly. ECG. S1q3T patern are seèn T INVERSTION IN in cheast lead. Pulmonary embolism with HOCM. DO 2D.ECHO.

X-RAY show Cardiomegaly with Pneumonitis Ecg show Biaatrial enlargement S1Q3T3 St depression in lead 3 aVf, v3 to v6 T wave inversion in v1 to v6 Persistent S wave in v6 IRBBB Echo must P.E is most likely here

Ant wall ischemia,right lower lobar consolidation present,needs higher antibiotics with O2 support, diuretics, bronchodilator s,tab.clopilet,CV, antihypertensive

X ray shows cardiomegaly and pulmonary edema. ECG shows S1Q3T3. Please go for pulmonary angiography

Ant. Wall ischemia c b/l lower zone consolidation. DO...2D ECHO. Start higher emperical antibiotic + high dose aspirin + clopidogrel + bronchodilators. O2 support.

Cxr- B/L haziness s/o pneumonitis/pulmonary odema ECG- S1Q3T3 wit T inversion in V2-6 Possibility f PTE Gt done echo n send cardiac markers Gt done CT pulmonary angio

Features of cardiomegaly.bilateral pneumonia might be viral etiologywith st depression.HOCM.ref to HDCU

Sub endocardial mi , with pulmonary edema treat give diuretics. avoid fluid overload.

ECG - S1Q3T3 pattern with RBBB S/O : Pulmonary embolism P pulmonale Lateral wall ischemia CXR - Pulmonary oedema Adv: 2 D echo, D dimer, CT thorax

Anterior wall ischemia with cardiomegally. Pneminitis with bil. Consolidation - more on Lt.- Needs ICU management for few day.

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