60F k/c/o bronchial asthma on Rx. Presentd with exertional breathlessness since 10days, cough with thick sputum, chest pain while coughing. Dx the ECG

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multiple wall ischemia anterior, lateral, inferior. LMWH, ecosprin 300 clopitab 300 atorvast 80 beta blocker accordingly BP and chest condition Follow up on ecosprin, clopitab, atorvast, beta blocker, moniterate, sorbitrate sl sos. Angiography.

ISCHAEMIC T WAVES IN CHEST LEADS ST T CHANGES II III aVF = CH CORPULMONALE CHEST PAIN DURING COUGH = INTERCOSTAL MYALGIA FREQUENTLY SEEN IN COPD CASES

P.Pulmonale St t changes in Inf leads & chest leads Arrowhead Deep T wave inversion S/O Cardiomyopathy Ischemia Need Echo

Well I am with Dr. dinesh kumar jis opinion, for further evaluation angiography is needed ,as said our Dr. dinesh ji. In cardiac ischaemia may occur b coz of asthma where there is to much respiratory causes a rise in intra thoracic pressure on myocardium and increase myocardium oxygen demand which is not fulfill so there are chances of ischaemia changes in ECG. management as Dr. dinesh ji has said. and angiography evaluation has to be done.

Inferolateral MI with LVH--LVF Is it the Bronchial asthma properly diagnosed with IgE Ab and is the history matching exactly? or is it LVF even previously Get some with cardiac enzymes and Echo possibly.

Symmetrical T wave inversion in anterolateral chest leads s/o ischemia

Lateral & septal wall infarction with anterior & inferior wall ischaemia.

Widespread t inversion HCM rule out Pulmonary embolism

Cardiac enzymes & electrolytes normal.

subendocardial ischaemia give aspirin 300 mg clopidogrel 300 mg atorva 80 mg lmwh send markers plan CAG and revascularisation

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