please interpret ecg 70 yes f h/o chest pain, perspiration+, nausea and vomiting, restlessness 2 hrs back h/o HTN, CVA no dm on telmisartan hydrochlorothiazide bp 200/92 pr 90/mt cvs,chest NAD CNS conscious, oriented

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Ecg is WNL except sinus tachycardia Since pt is aged and kco Htn with h/o cva complaing of chest pain with prespiration can not be taken lightly pt should be hospitalised and keep under observation with series of ecg and do cardiac enzymes and trop i also do 2decho and treat as a c/o ihd ie give nitroglycerin control bp as systolic is 200mm add metaprolol and give clopidogril+aspirin and modify as per lab results even angiography sos angioplasty may be option.

Thanx dr Satish Kumar
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PRESENT ECG IS NORMAL IT DOES NOT EXCLUDE IHD IN NSTME ECG MAY BR NORMAL CCG MONITERING TILL INCLUDE OR EXCLUDE M I TTOP I 0 HR & 3 HRS IF MORE THAN 99 % PRIMARY PCI REPEAT ECG IE NO PAIN 6 HRS --> STRESS ECG --->IF NORMAL D D --> DISCHARGE IF + VE --> CAG --> PCI

Shifting of transitional zone to V6 .In view of Old age,female ,previous history of stoke ,High BP reading ,need hospitalization,watch for stroke of infarction on evolution .Need caution on Asperin and clopidogril prescription in view of hypertention. control BP then one can start platelet inhibitor.

K / C / O..... H T...........H / o....C V A.. .BP...200 / 92..... Now...... CHEST. Pain..... Perspiration... ......Old. Age... ADVISABLE...... 1. Hospitalization 2. ECG....... ECHO 3. Cardiac. Enzymes.. 4. Nitroglycerin... 5. Clopidogril + Aspirin 6. Add. Antihypertensives..

Thank. U... Sir...
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In my openion its atrial flutter......rx vill b cordarone infusion....anticoagulants...mild sedation...oxygen n supportive rx

WNL Control BP and do serial ecg

Atrial fibrillation.

Accelerated htn a Hypertensive emergency ECG- normal Start Ntg drip Betablocker Statins Diuretics Antiplatelates once no<180 systolic Ace I/arb sos Watch carefully for any Neuro/ heartfailure sympt

ECG shows LVH. Pt should be admitted, iv diuretic, NTG, Aspirin, Trop-T & serial ECG should be considered. Pulmonary embolism should be ruled out.

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