74 yo male with history of HIV, Hep-C brought in by daughter after days of no appetite and persistent weight loss. Pt denied any symptoms, except for a “slight pain across his upper chest” before he came in. Pt was pain-free upon arrival. ECG obtained,. Troponin 0.108 ng/mL. Other labs within normal limits. Hourly ECG’s were obtained and no changes were noted. Patient remained pain-free during ER stay, and ended up being admitted for pneumonia and further chest pain workup. What is causing this STEMI-like pattern? The slight LBBB?

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High risk age group. Not mentioned if trop I or trop T as false positive can occur in pneumonia. R in V3 is is about 2-2.5 mm, J point in v2-3 less than 2mm, LAHB can explain all these. reciprocal depression in inferior leads not expected for v-v3. ST depression in inferior beads. You treat as US/ NSTEMI, ECHO, DELTA TROPONON, CPK MB

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Sinus rhythm, regular, 75 bpm, Axis LAD, LAFB, RWP good, ST elevation in V1 to V3, ST depression in L2, L3 and aVF. PVC. Anteroseptal STEMI. Repeat Trop-T, CPK-MB. 2D-ECHOCARDIOGRAPHY.

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Atypical pain upper chest ,age 74,Troponin positive &ECG changes in form of ST elevation is significant of IHD. Anterior wall infarction ? Echo.

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Anterior STEMI, With troponin l positive . Echo, CXR, lab test. Cardiologist opinion. Need further evaluation and Rx.

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Multi focal VPD if trop T normal ST Elevation may be due to Anureysum.

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Ventricular Aneurysm May be IVCD it doesn't look LBBB

LAD STEMI SEPTAL WALL OCCASIONAL VPC cTr after 3 hrs As of is symptom fee he is to observed for further symptoms He is to on STATIN DUEL ANTIPLATELETS ARB METOPROLOL ISOSORBRIDE DINITRATE SUBLINGUAL NITROGLYCERINE TR for HEPATITIS C & HIV. IF NO CHEST PAIN OLD PT WITH SO MANY COMORBITIES HE MAY BE DISCHARGED .SYMPTOM FREE ( PNEUMONIA + PAIN CHEST )

Antero-septal myocardial infartion.
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Anteroseptal STEMI , but no LBBB , probably due to HIV, Pneumonia severe inflammatory condition with high fever might have caused coronary spasm leading to STEMI.(lt circumflex coronary artery).

Low voltage in limb leads LAD LAHB Old Anterioseptal mi Check Lytes

That is STEMI only, do a echo Troponin is Positive (>0.02ng/ml)

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