Concluded Case

abnormal ecg

A female patient 56 yrs came with c/o breathlessness and mild chest pain around 2nd i/c space. h/o HTN and hypercholesterolemia since 6yrs.bp is 136/96 ,p-110/mt, cvs wnl, cns wnl, rs wnl. other vitals where normal. no c/o nausea vomiting and anxiety . her ECG is attached. kindly advice what should be my next course of action please.

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Concluded answer

Nirmal sinus rhythm, LVH. Pt in cp adv- Sr ECG, cardiac enzymes, Echo.

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RISK FACTORS FOR IHD ELDERLY FEMALE HTN ( DIASTOLIC PRESSURE STILL HIGH ) DYSLIPIDAEMIA PAINCHEST SOB TACJYCARDIA DIASTOLIC PRESSURE STILL HIGH ECG = q WAVE III & LEAD II Q WAVE > O. 3 SEC aVF OCCASIONAL ATRIAL ECTOPICS ATRIAL PACEMAKER FROM AT LEAST 3 DIFFERENT SOURCES RECOMMANDATIONS 1 SERIAL ECG 2 ECHOCARDIUM 3 CXR 4 BLOOD = CBC TROP -I . SUGAR CREATININE ABG 5 O2 INHALATION IF SATURATION . LESS THAN 94 % 6 ASPIRIN + PPI 7 NITROGLYCERINE SOS S L 8 IF SUGGESTIVE OF M I ------------> CAG --------> PCI IF INDICATED 9 IF NO EVIDENCE OF IHD & NO PAIN FEW HRS ----- > TMT IF + VE = PCI IF - VE = DD ,-----> DISCHARGE

Thank you dr samir. Complete in a nutshell.
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Ecg doesn't show any ischemic changes. Pl take serial ecgs.and get her cardiac enzymes & 2d echo done.by that time treat her symptonatically

Thank you for your reply sir. But she may be having LVH and q waves. Please guide
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Nirmal sinus rhythm, LVH. Pt in cp adv- Sr ECG, cardiac enzymes, Echo.

Thank you for your reply. How did you diagnose LVH sir. Please explain
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Single PAC otherwise normal Do Serial ecg

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