Palpitations !!

A male aged 50 years who is a k/c/o Mitral Stenosis on treatment Chief Complaints Palpitations Sweating (on/off) Physical Examination Essentially normal

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Tall peaked P wave in lead II suggest - Right Atrial enlargement likely to be caused by pulmonary hypertension

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ECG STUDY .. NSR .. RAD .. MS .. POSTERIOR ISCHEMIA ..

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Ischemia

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NSR Rt axis deviation LA enlargement

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-Tachycardia -Right Axis Deviation -Left posterior fasicular block -Mitral valve stenosis -Posterior Ischemia

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RAD LPHB RVH with strain

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Right axis deviation is seen s/o RVH

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