Concluded Case

COVID pneumonitis with ACS with CCF

50 year male presented with history of cough, breathlessness, fever since 4 days. He also had history of bee bite 4 days back. Even he had ST-T changes on anterior leads(ST elevation). On examination vitals were.. BP 96/60 SPO2 86 on air pulse 90/min immediately patient was referred for COVID testing by RT PCR n ICU admission. His report is awaited. share your views.

(Edited)

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Concluded answer

Given the current situation 1.covid2.pneumonitis b/l.3.anaphylactic shock with ARDS.4.ACS with pul.edema.5.Pul.tuberculosis with superadded bacterial infection.Should be investigated and evaluated accordingly.As for condition , patient should survive as he has got early ICU attention.Tough case although.

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Given the current situation 1.covid2.pneumonitis b/l.3.anaphylactic shock with ARDS.4.ACS with pul.edema.5.Pul.tuberculosis with superadded bacterial infection.Should be investigated and evaluated accordingly.As for condition , patient should survive as he has got early ICU attention.Tough case although.

PRESENTATION = .FEVER ---------------------- COUGH SOB SEVERE HYPOXIA ------------------------ H/ O PAIN CHEST =NOT AVAILABLE ECG = SINUS TACHYCARDIA LAD STEMI. ANTERIOR WALL CXR =:CARDIOMEGALY BILATERAL BATWING OPACITY MORE ON RT SIDE PULMONARY ARTERY ++ POSSIBILITIES 1 COVID I9 INFECTION WITH ANTERIOR WALL M I WITH SEVERE HYPOXIA + H F || | | FEVER SOB SEVERE HYPOXIA ------------------------ BATWING OPACITY OF BILATERAL PNEUMONIA 2 STEMI ANTERIOR WALL WITH LVF 3 BP IS 90 / 60 PRIOR BP NOT KNOWN PULSE 90 / MT HE IS NOT IN CARDIOGENIC OR BEE BITE SHOCK AND AS SUCH IS HISTORY HAS BEEN MADE CASUALLY NO ANGIOEDEMA URTICARIA MENTIONED

ECG NSR global MI with low voltage complex seen in lead 1 avL. Cxray shows bil mid basal inhomogenous opacities with prominent Pulmonary arteries. Possibly Pulmonary edema

H/o s Bee bite Clinically pt seems to be in anaphylactic shock Xray chest shows rt lower lobe homogeneous opacity likely pulmonary oedema sos pneumonitis Ecg suggest acute changes of ACS sbsequent AWMI Treat in ICU in emergency Monitor vitals

Thanx dr Parminder Singh
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ECG - Sinus tachycardia, Extensive anterior Wall mi,. Low voltage in limb leads. CXR PA view- showing Bilateral mid zone homogeneous opacity Rt>Lt.

Covid pneumonia with Acute STEMI in anterior wall, related to COVID. Investigations, cautious anticoagulation, supportive measures

Present condition of pt can b due to the sequence of bee bite! As x ray and ECG shows AW injury,treat anaphylactic reaction with due care for corona.

Ecg S.Tachy LAD LAHB Extensive Anteriolateral mi Now xray Rt sided haziness,, prominent P.Arteries so associated P.Odema Pt is in shock

Its pneumonitis with myocarditis. Pl get cardiac enzymes. 2d echo.could be because of bee bite. Covid is also another strong possibility

SUGGESTIVE. Of SINUS TACHY.. BILATERAL HOMOGENOUS. OPACITY

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