48/Male Presented with Severe Chest pain Since 1 Hr with Mild Dyspnoea and Left Arm Radiating Pain. History of Smoker and Stopped Alcohol 5 Year Back Pulse: 86 /min Spo2: 95% on RA BP: 140/80 Attached ECG

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Normal ECG. HTN?? Chronic smoker?? ?? Pneumothorax Smoking is an important cause of Chest pain due to Dislipidemia Wich causes narrowing of coronary blood vessels due to Arthosclerosis. ALSO long term smoking causes chronic cough and emphysematous changes. Do chest x Ray. Echocardiography.

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Normal tracing the character of pain suggests angina pectoris as pt has been smoker and alcoholic pulmonary functions are also to be checked as there is h /o dysponea

Sinus rhythm, regular, 75 bpm, Axis normal, RWP good, ST - T nonspecific. 1st degree AV block, U wave - hypokalemia. X-ray Chest, 2D-Echocardiography, CT scan chest, Serum Electrolytes.

Hyperkalemia do Trop T also.

ECG at present nothing specific U wave seen check for hypokalemia As complains are there repeated ecgs and cardiac enzymes to check

Hyperacute T wave in c2 c3 Do serial ecg

1st degree AV Block

V1 , T wave inverted, V2,3 STEMI septo right lateral infarction.

Sinus rhythm.Tall T waves in.v1-v2 Otherwise normal ecg

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