pt was a female aged 45 yrs came with co of severe headache and left sided chest pain on and off since 10 days no ho vomiting BP 130/80 mmhg pulse 63/min Afebrile systems normal Not a DM or HTN interpret ECG findings

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ECG shows inverted T in V1 to V3(juvenile T) ! Ventricular premature beat with fixed coupling interval ie unifocal --- nothing to do ! Headache can be due to hypertension also ! Present in 30% of the patient ! One important thing is low voltage ecg ! So go for echo and TSH ! Have an ecg during the chest pain and headache !

It is belived to have headache Mostly migrainous and cardiac arrhytmis like has got relation with no obvivious reason Cld b some autonomous system onvolvement Besides this one must look fr temporal vessel arteritis sign of connective tisdue disorder and associatef CAD especially proximal lad leasion in females Look fr CRP CHECK B12 FOLVITE

VENTRICULAR ECTOPIC

Yes sir Vpcs I just possibly corealating both
1

V.trigeminy T wave inversion in v1 to v3 Check S.troponin, Echo needs

Ventricular trigeminy, q waves in inferior leads, few waves have st elev in lead 2,aVF

Sinus rythm with ventricular trigeminy.

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