70 yr old male Hypertensive Non diabetic C/o dypnea n headache Bp- 170/100 Pulse -104 Ecg attached Dd/investigations/Rx?? Kindly reply

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Deep T wave inversion in I II aVL, V2-V6 Hypertrophic Cardiomyopathy (Apical varient)

Global T wave inversion This is observed in.... Takotsubo cardiomyopathy Kounis syndrome Apical hypertrophic cardiomyopathy Acute pericarditis Acute cerebrovascular event Electrolyte abnormalities Pheochromocytoma Pulmonary embolism Pulmonary edema..... And head ache is followed by Hypertensive Encephalopathy.. Reading both conclusion it is very likely to have ACUTE CEREBROVASCULAR EVENT. Pt must be shifted to ICCU under observation of Intervention Cardiologist.

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Significant T wave inversion in leads I aVL and V5 V6 which represent lateral wall and Giant T wave inversion in lead V2 - V4 which represent anterior wall This is suggestive of ischaemia of Anterolateral wall However other causes such as Pulmonary embolism, pulmonary oedema, subarachnoid hemorrhage, raised intracranial pressure need to be excluded

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Lvh Hypertensive heart disease Tab Lisinopril 20mg bd Tab spiromide 20mg Tab bisoprolol 5mg Tab loprin Tab rosuvastatin

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Sinus bradycardia NSTEMI Old inferior Wall MI Ad 2 echo again

NSR sinus bradycardia LAD ,LVH Arrow head T inversion in lateral leads and chest leads . ? Acute NONSTEMI in anterior and lateral wall. ? Hypertrophic obstructive cardiomyopathy ( HOCM) Observation, troponin, ECHO Head ache in hypertensive patient should suggest hypertensive encephalopathy, / hemorrhage/ SAH

Inferior wall ischemia with Twavr inversion

Sinu rhythm, giant T wave inversion in lead1 avl and precordial leads . D/D LVH with strain pattern Pt is hypertensive so chances of subarachnoid haemorrhage are more. Elevated intracranial pressure.

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Acute T inversion in L1L2 avl V2V3V4V5V6 Acute inferior wall ischimia

Ecg shows ischemic changes See for ct brain This changes also seen in hemorrhagic infarct or in stroke cases

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