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80 yr old follow up Pt of CAD presented with complaints of Angina on effort . Diagnosis and treatment plzz.

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There are deep Q waves in lead V1, V2 and V3 associated with T wave inversion suggestive of past anterior wall myocardial infarction There is T wave inversion in lead I, aVL and V2 to V6 - it is suggestive of ongoing Anterolateral wall ischemia It may point to NSTEMI advice Cardiac enzymes, 2 D ECHO and SOS angiography

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There are deep Q waves in lead V1, V2 and V3 associated with T wave inversion suggestive of past anterior wall myocardial infarction There is T wave inversion in lead I, aVL and V2 to V6 - it is suggestive of ongoing Anterolateral wall ischemia It may point to NSTEMI advice Cardiac enzymes, 2 D ECHO and SOS angiography

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Sinus rhythm,LAD,t wave inversion in lead 1,avl, and v2to v6 with prominent Q (v1to v6). D/D Anterolateral ischeamia. Old Anterior wall m I with late ral Wall ischeamia. Evolved extensive Anterolateral Wall m i. Needed compare if old ecg is available trop t, ECHO, serial ECG, Sr electrolyts, lipid profile,

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NSR left axis deviation. ST coving with inverted T waves in anterolateral leads. Findings sugg of evolved MI. Treatment antiplatelets statins nitrates nikorandil LMWH. Adv Echo CD and CAG. Thallium viability scan. If myocardium is viable, may consider therapeutic PCI.

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SUGGESTIVE OF L. A. D EVOLVED.... A. W. M. I NEEDS. FURTHER. EVALUATION

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Left axis deviation Lead 1 V4V5 T wave inversion ANTEROLATERAL ISCHEMIA

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Extensive AWMI,Confirm by Trop T. Shift to CCU for thrombolyse

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EXTENSIVE ANTERIOR WALL MYOCARDIAL INFARCTION

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Lad, extensive AWMI of some duration.

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Inverted T waves with antiplatelets

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This is case of old extensive anterior wall MI developing post MI Angina. There is no reciprocal changes in inferior lead . For to r/o reinfraction Troponin-T and Cardiac enzymes to be done. This case is to be manage like ACS but no thrombolytic therapy because patient is not allowing.

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