Concluded Case

60/M. C/O weakness, tremorlousness and palpitations. Chronic alcoholic. No signs of failure or fever. Kindly comment on ECG. electrolytes wnl.

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Concluded answer

Thanks all for help...sorry for the missing leads...

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Sinus arrhythmia, MAT, PAC occasionally,lead v5,6 missing, LVH ( largest R wave + largest s wave) in precordial leads> 45 mm. electral alternance,needs CXR PA view to r/o COPD, ECHO, electrolyts, LFT kft, TFT, Lipid profile, B's f,pp, HBA1c,cbc,

Electrical alternance is present
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Multiple premature atrial complexes seen

Incomplete tracings v5v6 are missing Rythm regularly irregular Premature atrial bests Cupping of st segment L2L3 avf St depression L1 avl Acute repolarisation of st segment in v1v2v3 Anteroseptal ischimia With hyperkalemia

Arrythmia sec to atrial ectopics. LA enlargement V5 v6 not visible to confirm LVH ( deep s wave in v2 and tall R in v4) Adv Echo CD TFT Electrolytes Renal functions LFT Anxiolytics sos betablokers. See for alc withdrawal.

Ecg reveals sinus tachycardia t inversion 1 avl v5 v6 couldn't be visible. It is more of alchohol withdrawal syndrome. However pl get his cardiac evaluation done

NSR, Multiple, multifocal APCs LAD , LVH ,LAE Inverted T and ST sag in L1, avL , ? Anterolateral wall ischemia ,? Part of LVH

Atrial fibrillation No visible P waves and an irregularly LVH Advice 2 D echo

Thanks all for help...sorry for the missing leads...

V5&6? Atrial ectopics

LVH PACS

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