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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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.

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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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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Acute Anteriolateral wall myocardial infarction. Treatment Thromboysis Anti platelets therapy Heparin therapy Angiography and proceed accordingly.

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

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

Sinus tachycardia NSR Acute repolarisation of st segment in chest leads suggest hyperkalamia

Thanx dr Ashok Leel
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S.Tachy St elevation is of CONCAVE type PR depression PERICARDITIS Dressler Syndrome

Sympathetic stimulation Trophy t test Echo cardiograpghy CARDIOLOGIST consultation

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