61 years female patient complains chest pain and vomiting one episode since one day no other complains BP 150/90 tmp Normal spo2 99 hr 80

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Inferoposterolateral STEMI Record v3R and v4R leads too for RV Extension..Serial ECG monitoring Cardiac monitoring/vitals chart/ treat hypsrglycemia O2 if slow below 90 2large bore IV cannulae..IV fluid with saline if no dyspnoea Immobilization Aspirin 300mg to be chewed followed by swallow Ticagrelor or prasugrel..If PCI facility available otherwise clopidogrel Atorvastatin 80mg Fondaparinux better or lmwh PCI will provide pain relief If PCI not available..Thrombolysis window of 12hours..Earlier the better...prefer reteplase or tenecteplase or accelerated rtPA over streptokinase Monitor for Bleed if thrombolyzed N evaluate for successful thrombolysis May need rescue PCI if failed thrombolysis Echocardiography To assess the RWMA and EF R/O Free wall rupture/ VSD/ Papillary muscle rupture..Ischemic MR..Prognostic / intervening findings Cardiac monitoring throughout Judicious use of diuretics if lvf No nitrates or other vasodilators or beta blocker in infpost MI Please add rest of the things

If hypotension ...Need to start normal saline Ionotropes to be avoided till we can...Noradrenaline as ionotropes best avoided if no septic cause of shock...NE not good in cardiogenic shock.
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Its a case of inferolateral myocardial infarction.

Inferior wall myocardial infarction.reciprocal changes inanterior leads. Or ischemia at distance. A complicated iwmi.

Acute myocardial infarction. Needs urgent admission. Serial ECG and enzymes.

Inferior + posterior + lateral wall STEMI, LAD, RBBB+ LAFB

Inferioposteriolateral mi

Inferior lateral MI

Inferior lateral MI
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INFERO POSTERO LATERAL MI

Inferolateral wall mi

O2 if SPO2 LESS THAN 90

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