46 year old male patient presented with Chest pain difficulty in breathing and decreased heart rate. His ecg is attached. Please diagnose.



ECG- sinus bradycardia 42/min, ST elevation , T inversion in V1-V3- (looking like ASMI) and prominent U wave v2&v3 , ST/ T in v5& v6 looking like that of early repolarization. The QTc is very short 350ms, which does not favour myocardial ischemia. However as the presentation is chest pain with ECG abnormality needs to be evaluated for CAD.

Anterior wall MI

S.bradycardia St elevation in v1 to v3 Biphasic T wave in v2, v3 Wellen's syndrome if ecg is recorded during painfree period

NSR, sinus bradycardia ? EVOLVING Anteroseptal STEMI Needs observation, serial ECGs, troponin, and angio.

T inversion in v12 Biphasic t waves in v3 chest pain s / o wellens syndrome dual antiplatelet LMWH NTG statin early CAG

@Dr. Diksha Bhardwaj sir his ECG is seen @Heart is weak, like blockeg , BP, CBC and esr? Tab.Sarparju 1 bd, Tab.Prabhakar bati2 bd, Tab.Sutsekhar Ra's 2 bd, Tab.Kanchanar guggul 2 bd, Arjuna rist 20 ml with warm water bd.

Its V1V2 t inversion give loding dose and inj Aggriblock infusion.do 2decho and cardiac marker its ischemia

And advised CAG

Sinus bredicardia.& pt.have Anterior MI.with wellens phenomena.IT indicate block in proximal part of LAD.?With sick sinus syndrom

Antero septal injury Start anti platelets Statin Nitrates Heparin Do blood investigation Cardiac enzyme Lipid profile Do early CAG

Anterolateral wall ischemia....needs thrombolysis

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