A morbid obese female with Chest Pain

A female aged 45 years with BMI- 35 Chief Complaints Pain Chest Recurrent Giddiness (x 3 days) Vitals BP- 160/90mmHg Physical Examination B/L Pedal Edema Mild Pallor

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A short PR interval in lead 2 , 3 , avF and chest leads with tachycardia and presence of Q wave . Could be Junctional arrhythmia like AVNRT or WPW syndrome. Or CAD Needs evaluation by ECHOCARDIOGRAPHY,

Sinus tachycardia otherwise WNL Pt is morbidly obese R/o hypothyroidism Mild hypertension Tab metaprolol+hydrochlorthiazide Tab ecosprin

Short pr interval q wave in inf leads cad advise echo

P.Pulmonale

P.pulmonale 2D echo is necessary

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