56 year old lady presented to the emergency with hemiplegia and palpitations. Comment on the ECG

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ECG_ Acute antero-septal STEMI, The cause for hemiplegia could be due to Atrial Infarction( which causes thrombo- embolism, atrial arrhythmia- fibrillation) as evident by deformed notched P waves, PR segment depression in inferior leads and prolonged PR segment- 220ms. Treatment modalities depends on clinical situation and should be instituted after complete evaluation.

Sir as patient is having ischemic stroke and STEMI at a time how to thrombolyse? Which fibronolytic agents are safe??? Thanks in advance
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Anteroseptal AMI. Might have developed arrhythmias to start with and thromboembolism hence presented as CVA.....hemiplegia. Urgent thrombolysis will help. Possible complications should be monitored and managed accordingly. Also add mannitol.

ST Elevation in V1-V3 without Chest Pain & that without STD in reciprocal leads...STEMI is of least possibility. It is probably a case of recent MI with Ventricular Aneurysm with clot in Aneurysmal dilated LV with Cardioembolic Stroke ADV.2D Echo.

Anteroseptal STEMI with cardioembolic stroke poor r wave progression poor LV function rule out LV clot by echo as patient is having ischemic stroke also thrombolyse with alteplase with accelerated infusion over 1 1 /2 hr

Established phase of anteroseptal infarction. Thrombolysis won't help.What is the duration of hemiplegia.A CT is required to evaluate the cause of CVA,embolic or otherwise.Institute treatment for CAD,if embolic than low molecular wt heparin will help.If CVA is recent than stabilized the patient and go for PCI as early as possible.

Anteroseptal myo infarction

1'AV block St elevation in v1 to v4 Biphasic T wave in v2 to v4 Anterioseptal mi

Dr. Iliyas Sheikh sir please share your views

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