Concluded Case

severe pulmonary stenosis

19M came with C/O fever since 2 days. No past history of any cardiac disease. No H/O SOB/palpitations/PND/Orthopnea/Syncope. O/e systolic murmur+ over all 4 regions of chest best heard at pulmonary area. No signs of inf. endocarditis. kindly comment on ECG and possible etiology.

(Edited)

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Concluded answer

Thank you everyone. This is a case of severe pulmonary stenosis(pressure gradient 60mmhg). Patient is asymptomatic. On routine examination it was found. ECG showing RAD with increased R wave amplitude in V1 and aVR. Echo showing Severe PS(60mm hg), dilated RA and RV.

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Normal sinus rhythm Rt axis deviation with p pulmonale in lead 2,3and avf suggestive of cor pulmonale or Rt side heart failure with severe TR go for 2D echo test.

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Thank you everyone. This is a case of severe pulmonary stenosis(pressure gradient 60mmhg). Patient is asymptomatic. On routine examination it was found. ECG showing RAD with increased R wave amplitude in V1 and aVR. Echo showing Severe PS(60mm hg), dilated RA and RV.

NSR Rt axis deviation. T wave inversion in lead 3. Positive R wave in v1 and avR. Adv Echo CD.

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Normal sinus rhythm,r wave prominent in AVR and lead V1 with t wave inversion in lead V1 and deep s wave in v6. Possibility of rt sided heart strain.

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Right Axis Deviation, Left Posterior Hemi Block RBBB Needs ECHO ,XRAY CHEST, cardiac assessment ? Pulmonary stenosis , ASD Needs blood culture

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U waves seen in ecg..check serum k+ levels. Rule out Anemia as a cause of murmur..Routine tests for evaluation of fever.

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RVH=R wave prominent in V1 and rt axis deviation Echo to r/o ASD

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RBBB

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Sinus rhythm , RBBB.

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T wave inverted in lead 3 & v1 lbbb do 2 decho

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