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
ECG shows LVH. Pt should be admitted, iv diuretic, NTG, Aspirin, Trop-T & serial ECG should be considered. Pulmonary embolism should be ruled out.
WNL Control BP and do serial ecg
ECG looks wnl except sinus tachycardia t wave is seen flattened in v leads
Lvh
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
Atrial fibrillation.
In my openion its atrial flutter......rx vill b cordarone infusion....anticoagulants...mild sedation...oxygen n supportive rx
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..
Tab nicardia 20 mg bd Tab etizola. 0.25mg bd tab lipikind plus 0d tab stimitil md bd
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.
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