A 45 yr old female presented to emergency dept with c/o uneasiness over chest, chest pain, anxiety and palpitations since last 1 hr. There is no h/o any pain radiation, vomiting , headache or heart burn. BP was 124/84 and PR was 101. Suggest DD and Mx.


Baseline artefacts that causes st depression in chest leads Some beats r normal some hv depression Need to repeat ecg

avr t wave depression , avl st depressed , v2-4 st depression , tall qrs complexes in chest leads Suggests - Hypertension , rt wall ischaemia of heart (CAD).

Ecg is nornal...keep pt under obsevation..do 2d echo.repeat ecg chest xray cbc to rule out anemia and rft

Normal ecg. Give analgesics,ppi,repeat ecg after 2 hrs

Appears to be acute anxiety only

ECG- Normal sinus rhythm.

ECG normal

LVH Gt echo done

Normal ECG

The case was probably of acute anxiety. Was relieved with PPI and anxiolytics . Follow up ecg and 2d echo has been planned.

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