sudden onset of breathless ness in a45 yrs old male patient, Known case of diabetes on irregular treatment diagnosis?



Xray show loss of aortic knucle ,with diffuse infiltrates may be due to pulmonary oedema Tlc raised may be due to LRTI Ecg show Q3 T3 pattern s/o pulmonary embolism with LBBB and st elevations in v1 to v3 with vpb (If its a new onset of lbbb it goes towards MI so it should be rule out by his old ecg if you have it) Final provisional Diagnosis is PULMONARY EMBOLISM send D-dimer

sinus tachycardia, 125 bpm, irregular, occasional PVC, RWP- good, Axis- normal, LBBB, LVH with strain pattern, left atrial enlargement, PAH, ac. LVF. X-ray chest- cardiomegaly, PAH, Pulmonary congestion,secondary bacterial infection, left pleural effusion. NT-ProBNP, 2D-Echocardiography. treat as ac LVF

2DECHO and Troponin I with electrolytes are required. It seems to be infection related cardiac decompensation. There may be silent MI. ECG is showing LBBB pattern with few VPBs.

St elevated in v2 and v3 , x - ray shows diffuse infiltrate , May be due to pulmonary oedema. Diagnosis is STEMI- it may be silent due to DM

left pleural effusion, pulmonary oedema

Pulmonary oedema nonsustained vt

@Pul Embolism with pul oedema

Pulmonary oedema

Pulmonary oedema

CXR. Hyperinflation COPD also. Rt.MZ & Left. LZ Tuberculos infiltration. ECG. Arrythymia. VPC are seen. ST Elevated in V1 - V3. Reciprocal change in inferior. Loss of RWP.. ANTERIOR WALL M.I. LBBB. ARDS Pt. Is in high Risk STEM.And in Kllip class -||| With respiratory failure - type -1.So that. Do very much urgently 2D.Echo and tropnine.. Sputum for AFB and also Sputum for Culture and sensitivity. Sent for CAG and PTCA.

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