58 y female Post cardiac arrest - revived in outside clinic GCS on arrival 15/15 Patient known diabetic and hypertensive on regular medications .. correlate both abg and ecg and suggest what can be cause of arrest and advice further line of management !!

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Sinus tachycardia, regular, 114 bpm, Axis LAD, LBBB, RWP absent, ST elevation in V1 to V6, slight ST elevation in L2, L3 and aVF, ST depression with T inversion in lead L1 and aVL. Extensive Anteroseptal STEMI with involvement of the Inferior wall. Treat as ACS with thrombolysis by tPA. Send the patient for urgent CAG and ANGIOPLASTY /CABG. ABG - partially compensated Respiratory alkalosis, hyponatremia, hypocalcemia, low BE, low AGap, lactic Acidosis, Hyperglycaemia. Prognosis is very poor.

Sinus tachycardia LAD LBBB Compare to old ecg wether it's new changes of LBBB or not Do 2decho and cardiac enzymes mostly comes positive after CPR but repeat after 24 hrs also Abg resp alkalosis Lactic acidosis Hyponatremia nothing significant ACS to rule out

SINUS TACHYCARDIA LAD RBBB NON PROGRESSION OT T UPTO V6 ANT WALL MI CAN NOT BE RULED OUT . . Respiratory Alkalosis . METABOLIC ACIDOSIS . HYPONATRAEMIA HYPERGLYCEMIA BLOOD cTr AT 0 & 3 HRS RPT ECG IF cTr > 90 percentile C A G P C I WITHIN 12 HRS

ECG Sinus tachycardia, LAD, LAFB, lateral wall ischemia, anteroseptal MI Poor progression of R in chest leads ABG Respiratory alkalosis with hyponatremia and hypocalcemia. and hyperglycemia, lactic acidosis MI, hypotension, hypercalcemia could have caused Cardia arrest ..

Lead 2,3 avf stelevaation STEMI inferior wall infarction, lead1 t wave inversion, avl , v5,6 st elevation Anterior wall infarction,v1-6 STEMI GLOBAL ZiNFARCTION. Cause Hyponatremia & hypocalcemia .

- 30° - 90° LAD Wide ventricular complex 0.12 sec. Predominantly negative rS Lead intrinsicoid deflection

ECG. ST Elevated in inferior lead.and also ST Elevated in chest lead. Extensive Antero - Inferior wall M.I. Ventricular conduction are delay. Urgently do 2D.Echo and tropnine. Sent for CAG.

ECG has evidence of Anterior wall Myocardial Infarction under resolution.keep him under observation for arrhythmia and recurrence of MI. Echo,PCI Cardiac enzymes. Continue Medication of DM and HTN . ABG near normal n does not require treatment.

Hyperkalamia with hyponatrimia and hypoxia sinus tachycardia and wide qrs complexes suggesting Rbbb

Thanx dr Ahmed Ali
0

A flatter, anterior Wall mi ,lbbb,old iferior Wall mi,

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