Concluded Case

46 yrs male pt presented with progressive dyspnea, exertional angina and facial edema since last 8days. known hypertensive and on beta blockers. BP 110/80.mhg spo2 94% sr creat 0.9 BSL 98 Hb 8 wbc 4300 plt 1.9 adv Echo, TFT. and started diuretics plz interpret CXR and ECG.

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Concluded answer

ECG shows - Q waves seen in lead V2 - V5 suggestive of old anterior wall myocardial infarction X ray shows - Patchy opacities in right lower zone suggestive of Pulmonary oedema/ Bronchopneumonia

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ECG Small voltage complexes. Qs in V1 to V5. OLD ANTERIOR WALL MYOCARDIAL INFARCTION X-ray chest KERLE B LINES.. Increased bronchovascular markings IMPRESSION POST MYOCARDIAL INFARCTION FAILURE Coronary artery disease Adv ECHO, reduction of beta blockers, add diuretics, ARBs, salt and fluid restriction,ADMISSION AND TREATMENT

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ECG shows - Q waves seen in lead V2 - V5 suggestive of old anterior wall myocardial infarction X ray shows - Patchy opacities in right lower zone suggestive of Pulmonary oedema/ Bronchopneumonia

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Poor progression of R wave Low voltage complexes in many leads b/l haziness in lung bases ?failure due to Anemia Blood Transfusion

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Sir,ecg shows q waves in chest leads,low voltage complexes,cxr shows b/l hazziness d/t ?fluid overload .do 2 D echo to r/o pericarditis or cardiac tamponade.what about auscultation findings sir?

T wave inverse in lead v1-v3; probably myocardial ischemia, cxr seems to be within normal limits. Pt is anaemic.

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Ecg Low voltage Old AWMI Now to establish reason of failure is Anemia /Post MI

old Myocardial infarction looks like depresed EF below 30 due to that piture looks like angina diruretics recomended and blood trandusion will be helpful for early recovery

Chest scan NAD.

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I think the decision will depend on echo report  I reduced EF heart failure is confirmed than adding of ORNI ( Valsartan-Scubutil) combination will be beneficial  For Anaemia total dose of Orofer FCM IV in 100 ml saline should be beneficial  It is better to hospitalise and monitor

Anemia with ant wall mi ,x-chest -wnl, Anemia with hypoprotenemia and post ant wall mi Adv-CBC-types of anemia-?microcytic,megaloblstic LFT -status -serum protein,Urine-protenuria  Echo-Cardic function EF,wall motion abnormality  JVP-? Chest-crepts? Abd-hepatomegly ,ascitis? Tt-inj dytor ,ramipril ,ecosprin ,rosuvastatin Tt -Aemia

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