Good morning Dear Curofians.. Patient was 62 years old lady, Known Diabetic presented with chest pain n palpitations. Diagnose this condition n mention further investigations n treatment plan. Regards.


Sir I think its sick sinus syndrome - Tachycardia-bradycardia syndrome variant.would it be possible to do a holter monitoring sir? Treatment wise it's pacemaker implantation.drugs to control arrhythmia will exaggerate kindly let me know the exact diagnosis sir.
Perfectly alright
It's a Sick Sinus Syndrome also known as Tachy Brady syndrome.. Needs Holter monitoring. Electrolytes n TFT were normal. CAG to be done to rule out underlying CAD as she is Diabetic. In this lady CAG was Normal. Pacemaker implantation would be ideal as per management part.
Thank you sir..

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St depression in lead v2 to v6 Downup T wave in v2 to V6 S.rhythm followed by SVT Check lytes Echo followed by Holter
DM with ischemia in lateral Wall,may Land into infarction, admit patient ,send blood cardiac markers, blood sugar, start low dose heparin, orally anxiolytic,clopilet, aspirin,sorbitrate sos sublingual and take opinion of cardiologist
Brady tachycardia syndrome...AAA can't be given to this lady as fear of life threatening bradycardia or cardiac arrest can occur so permanent pacemaker implantation is treatment of choice
Ischemic Af with healing AWMI What about blood pressure Load with antiplatelate Statin If blood pressure permit low dose ntg Heparin Send cardiac profile Plan for COronary angiography
Low voltage. T depression in V 2 V 6 .difference in height of R waves. But no definite electrical alternance. Ischemic chest pain. Pericardial effusion?
Heart rate differs from first few beats to next. Both normal and tachycardia.

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She is old lady ,diabetic,hypertension,lipid profile,cbc,diabetic gastropathy all these reasons along with the cardiac reasons should also be looked upon.
Just look at the rhythm n HR on both ECG n I will be able to clinch the diagnosis.
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