48yrs old male....chest pain since 2days , left sided chest , severity pain 2/5, heaviness in left upper limb....know case of hypothyroidism old syncope 2yrs back ...since then tab ecosprin atorin ..thyronorm .Bp110/70 and sapo298. Blood invest...creatine kinase 250, troponin i elevated..rest normal limit...
S.bradycardia 60bpm St elevation in lead3 St depression in lead2,3&avl Inverted p wave in v1&2 Inverted t wave in lead v3-4-5 Inverted t wave with st depression in V6 Infero lateral wall ischemia
Hypertension. High BP is the most common cause of chest pain. When BP is elevated, the small coronary arteries within the heart collapse as the ventricle tries to pump blood against high pressure. The pain may dissipate as BP returns to normal.GI causes of chest pain Heartburn. As stomach acid refluxes back into the esophagus, a patient may complain of a burning sensation behind the sternums Chest pain: When should I be worried? Vascular cause of chest pain Hypertension. High BP is the most common cause of chest pain. When BP is elevated, the small coronary arteries within the heart collapse as the ventricle tries to pump blood against high pressure. The pain may dissipate as BP returns to normal. GI causes of chest pain Heartburn. As stomach acid refluxes back into the esophagus, a patient may complain of a burning . Caused by part of the stomach ascending above the diaphragm, this condition can cause chest pain or pressure. It is especially noticeable after eating. CONTINUE READING Peptic ulcer perforation. Also known as a perforated ulcer, this emergency may present as lower chest pain, tachycardia, hypotension, and changes in the electrocardiogram. Cholecystitis. Inflammation of the gallbladder results in right-upper-quadrant abdominal pain that may radiate to the right side of the chest. Typically, this condition follows a high-fat meal and may be accompanied by nausea and vomiting. Acute pancreatitis. In this condition, severe pain is described in the left upper quadrant and may radiate into the left chest. Lying supine worsens discomfort. Pain may also be accompanied by nausea, vomiting, and fever. Lifestyle causes of chest pain Alcohol. Excessive alcohol consumption can make the heart beat faster and harder. Alcohol may also produce dysrhythmias, which can lead to MI. Smoking. Cigarette smoking increases BP and heart rate. These factors, coupled with the increased amount of carbon monoxide in the bloodstream, may cause chest pain. Cocaine. Cocaine use increases heart rate, BP, and contractility of the left ventricle. This drug also causes coronary artery vasoconstriction, leading to chest pain. Miscellaneous causes of chest pain Severe anemia. A patient with severe anemia may experience chest pain, fatigue, palpitations, and shortness of breath on exertion. Stress or panic attacks. These risk factors lead to hyperventilation and rapid heart rate, resulting in chest pain. Thyroid disease. Hyperthyroid and hypothyroid states are potential causes of chest pain. In hyperthyroidism, the heart rate is elevated, even at rest, leading to chest pain. In patients with hypothyroidism, the heart rate will be very slow, and heart function will be impaired. This can cause pain during exertion. Treatment Hyperthyroidism is readily treated and cured in some cases. With prompt diagnosis and treatment, high levels of thyroid hormone can be returned to normal levels in the body. With regular medical care and monitoring of hyperthyroidism, many people have an active, normal life span. Treatment of hyperthyroidism includes: Beta blockers, which can minimize some symptoms, such as rapid heart rate and anxiety Antithyroid medications, which decrease overproduction of thyroid hormones. In some cases, antithyroid medications may cure hyperthyroidism. Regularly testing levels of thyroid hormone in the blood and adjusting, if necessary, the dosage of thyroid hormone used to treat hypothyroidism Surgery to remove an overactive thyroid gland may be performed in some cases of hyperthyroidism. This may cure the disorder. Swallowing of radioactive iodine, which reduces overactivity and overproduction of thyroid hormone
LBBB Arrowhead Deep T wave inversion in lead 1, aVl, v3 to v6 Here Trop I is positive so Rx as NSTEMI
ECG HCM
D winters T waves,repeat ecg
Hyper trophied cardiomyopathy
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Patient complains of sudden onset pain in epigastrium region, retrosternal discomfort. ECG done. What is the diagnosis?
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F 30 multiparty attended ER with c/o severe pain abdomen on Rt hypochondrium radiating towards mid abdomen mainly upper epigastrium & to the back with shivering (due to cold) with 2 episodes of vomiting.No HTN,No DM. Advice USG abdomen,ECG,CBC, Amylase Lypase,LFT, Treatment NPM,IV fluids 6 hourly,Inj Cefrrixone 1gm BD Inj Amikacin 500mg BD,Inj Pantaprazole 40 mg BD,Inj Tramadol 100mg TDS,Inj Diazepam,Inj Metronidazole 500mg TDS,Inj Onsansetron stat & SOS,Inj Drotavarin 80 mg stat.Interpret ECG,PD & Line of management.Sorry for tracing quality.
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58/M chronic smoker and alcoholism present with severe excruciating pain in epigastrium extending both hypochondria since 2-3 days. No fever, SoB, Vomiting, gi bleed, altered bowel or bladder. Tolerating orally. CBP, ECG, amylase lipase.....WNL. This is Abdomen x-ray erect position. possibilities?
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