CROCHETAGE SIGN

37 year old male admitted with increase shortness of breath for last 7 days. He had history of severe chest pain 1 year back. He has also been suffering from shortness of breath for last 1year. No other history or documents available. Below is the ECG at present times. Diagnosis/possibilities?

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ASD (Ostium Secondum) : 1. Dominant R in V1 with narrow qrs duration....Incomplete RBBB 2. RAD 3. RVH 4. Crochetage sign (nothed R in lead II & III) Post Anteroseptal MI (Recent) : Presence of Q waves with T inversions in lead V1-V4.

Ecg R wave in v1 Right Axis deviation T wave inversion from v1 to v4 Patient has either congenital ASD or pul stenosis causing rvh Rvh is causing ischemic pain

Because there is no p pulmonale so pul hypertension is less likely. Start treatment with Tab ramipril 2.5mg. od Tab cardnit 2.6mg. TDS Tab metoprolol 25mg. Bd

Sinus tachycardia, RAD,S1Q3T3 pattern, RVH, RBBB pattern ,T wave inversion in Inferior leads and chest leads, occasionally PAC, pulmonary embolism??

RAD LPHB RBBB with secondary repolarization changes Old Anterioseptal mi ( Q wave deveopled) Ongoing lateral wall mi

RVH with strain pattern Adv: 2 D echo / CxR to rule out pulmonary hypertension, CHD, COPD

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