ECG challenge: a confused ECG!

Patient male, 42 years old. Sudden postoperative pain in the sternum for 3 days in the emergency department, the electrocardiogram is shown below. Emergency room BP160 / 102mmHg, symmetrical blood pressure in both upper limbs, double lungs (-), early diastolic murmur in the aortic valve area. Discussion: 1. ECG analysis. 2. Diagnostic considerations? 3. What to check next?

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Lateral wall MI. Hyperkalemia?

NST Tachycardia Changes of MI Adv: ECHO Cardiac markers

1 SINUS TACHYCARDIA ST ELEVATION WITH CONCAVITY UPWARDS LEADS I II .aVL V2- v6 2 POSSIBLY PERICARDITIS APPEARANCE OF DIASTOLIC MURMUR SUGGESTIVE OF INFECTIVE ENDOCARDITIS HE HAS HTN ALSO 3 BLOOD CULTURE BLOOD CBC CRP PROCALCITONIN TROP I ECHOCARDIUM REPEAT ECG LOOK FOR PERICARDIAL RUB

I agree
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NSR Tachycardia / LAD Needs further investigation into evaluation to conclude that lime of treatment. Cardiac enzymes,electrolytes and 2D Echo.

Thanks Dr Ramesh Kumar Singh
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Sympathetic stimulation Trophy t test Echo cardiograpghy CARDIOLOGIST consultation

St elevation in lead 1 AVL and v5.v6.high lateral wall ischemia .do cardiac enzyme .treat as acute coronary artery syndrome

Sinus tachycardia stemi with posterior infarction hyperkaelemia 2 decho tropi & t regurgitation of aortic or pulmonary valve

Looks like early repolarization
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Acute Antero-lateral Wall MI.. Need CAG.. Stenting with Revascularization..

NSR/Tachycardia/LAD/ Do lopid profile, serum Electrolyte, Thyroid profile Xrdiac Trpi -I& II, CPKMD, CXR P/A, 2D Echo, ASWMI, ACS, HTN,

NSR LAD early repolarization seen in anterolateral and inf leads. Calibration of ECG not seen. Could be reversal of leads. Adv repeat ECG Cardiac enzymes Sr electrolytes 2d Echo CD.

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