A female of 58yr having chest pain anteriòrly bilaterly and back interscapular region since 6hrs.BP 120/80mg non diabetic .no past history of any comorbid disease.GPE and systemic examination normal.ECG ìs enclòsed kindly Dx and aRx.

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ECG s/o an extensive anterolateral STEMI. ST elevation seen in leads I, aVL and V1-5. Reciprocal ST depression seen in III and aVF. A CAG is advisable on an urgent basis. Do not wait for the patient to become haemodynamically unstable. Antiplatelets and Vasodilator therapy to be given in the meantime.

Sinus rhythm, st segment elevation in lead 1 and AVL V1 to v5 suggestive of Extensive anterior Wall m i. Needs cardiac enzymes , ECHO, treat as ACS protocol.

Lead3,avr, avf, v1 Twave inversion , Lead 2, avl , v2--5 ST elevation suggests rt lateral & inferior wall infarction & remaining part except post Left lateral viz., anterior& septal STEMI

LAE STEMI ANTERIOR WALL GIVE NITROGLYCERINE S L ASPIRIN TO CHEW + A PPI SEND TO A PCI EQIPPED HOSPITAL-------------------> O2 IF SATURATION LESS THAN 94% CAG PCI WITHIN 2 HRS

Acute Anteroseptal infarction of some duration, reciprocal changes in inferior leads . Treat as ACS and go for pci if in suitable center as time to thrombolyse is over.

Extensive anterior wall M.I , Tab.clopilet75 mg -4 tab,tab.aztor40my-2 tab,tab.disprin-1 tab,inj .pan,zinger to be given Take him for primary if in window period

Anterolateral wall MI STEMI

Anterior wall MI

Extensive anterolateral MI
0

Hypokalaemia.

Extensive anteririor wallMI

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