Pages

Tuesday, August 22, 2017

A 55 Year Old Man Presents To Emergency With Chest Pain For 6 Hours...

The ECG shown below was recorded in the A & E department from a 55-year-old man who had had chest pain at rest for 6 hours. There were no abnormal physical findings.
What does the trace show, and how would you manage him?


The ECG shows:
• Sinus rhythm
• Normal axis
• Normal QRS complexes
• ST segment depression - horizontal in leads V3-V4, downward-sloping in leads I, VL, V5-V6


Clinical interpretation
This ECG shows anterior and lateral ischemia without evidence of infarction. Taken with the
clinical history, the diagnosis is clearly 'unstable' angina.

Diagnosis
Anterolateral ischemia.

What to do
There is no evidence of any benefit from thrombolysis. The patient should be given aspirin and intravenous heparin and nitrates. At the time the record was taken, he had a sinus tachycardia (at a rate of about 130/min) and if this does not settle quickly, intravenous beta-blocker would help.

6 comments:

  1. I was diagnosed with stage 3 breast cancer in August of 2010. A precious friend told me about Dr Itua Herbal Center in West Africa,She gave me his contact number and email address,I contacted him quickly so he give me guaranty that his herbal medicine will cure my cancer and i will be heal forever I said Okay.I ask him about the process for the cure,he ask me to pay for the fees which i did and within 7 working days he sent me the herbal medicine then he instructed me on how to drink it for two weeks to cure.I told Gomez my friend about the herbal medicine so he gave me go ahead to drink it.So after drinking it for two weeks i was cured I'm so grateful and i promise i will recommend anyone with cancer to him and that what i'm doing.Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's disease,Schizophrenia,Cancer,Scoliosis,Bladder Cancer,Colorectal Cancer,Tach Disease,Ovarian Cancer,Pancreatic Cancer,Breast Cancer,Kidney Cancer,Leukemia,Lung Cancer,Skin Cancer,
    Glaucoma.measles, tetanus, whooping cough, tuberculosis, polio and diphtheria, Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,Obsessive Compulsive Disorder,
    Dementia.Uterine Cancer,Prostate Cancer,Fibromyalgia,a
    Syndrome Fibrodysplasia ,Parkinson's disease,Epilepsy Dupuytren's disease,
    Diabetes ,Coeliac disease, Angiopathy, Ataxia,Arthritis,Tach Disease,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes.
    Here Is His Contact Info......[Email...drituaherbalcenter@gmail.com/ info@drituaherbalcenter.com. Whatsapp...+2348149277967]

    ReplyDelete
  2. I have been cured through Dr Oseghale African Traditional roots and herbs.
    Why so many people don't succeed in better health is because they have the belief that herbal medicines are primitive and outdated they took time ?
    in thinking and having much doubt in herbs that can actually better their health naturally.
    Do you know that thinking and doubting won't solve your health problems?yes of course it won't solve it All
    you've to do is to stand up again and make the best move in your life.
    African herbs cures HIV, HSV, CANCERS, INFERTILITY, ASTHMA, PARALYSIS, DIABETES Try a reliable herbalist like Dr oseghale and tell him your symptoms and feelings on;
    Oseghalesunday07@gmail.com
    CALLING +2347062814871
    WHATSAPP LINE +2347062814871

    ReplyDelete
  3. I have been cured through Dr Oseghale African Traditional roots and herbs.
    Why so many people don't succeed in better health is because they have the belief that herbal medicines are primitive and outdated they took time ?
    in thinking and having much doubt in herbs that can actually better their health naturally.
    Do you know that thinking and doubting won't solve your health problems?yes of course it won't solve it All
    you've to do is to stand up again and make the best move in your life.
    African herbs cures HIV, HSV, CANCERS, INFERTILITY, ASTHMA, PARALYSIS, DIABETES Try a reliable herbalist like Dr oseghale and tell him your symptoms and feelings on;
    Oseghalesunday07@gmail.com
    CALLING +2347062814871
    WHATSAPP LINE +2347062814871

    ReplyDelete
  4. I was diagnosed of herpes virus in 2015, I have tried all possible means to get cure but all my effort proved abortive, until a friend of mine introduced me to a herbal doctor called Dr Onokun  who prepare herbal medicine to cure all kind of diseases including herpes virus (Hsv), when i contacted this herbal doctor via his email, he sent me herpes virus herbal medicine via courier service, when i received the herbal medicine he gave me step by step instructions on how to apply it, when i applied it as instructed i was totally cured from the virus within 2 weeks of usage. Contact this great herbal doctor today to get your cure.
    Via Email : Dronokunherbalcure@gmail.com

    ReplyDelete
  5. DR AGBOMIAN herbal medicine is a good remedy for herpes simplex virus cure. My name is LOGAN BATE, am from USA,I am here to give my testimony about DR AGBOMIAN who helped me in my life, i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by DR AGBOMIAN , i visited different hospital but they gave me list of drugs like Familiar, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how DR AGBOMIAN cured them, when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without any problem, my HERPES result came out negative, I pray to God to never let me and my family forget you in our life, am now cured permanently, you can also get your self cured my friends if you really need this doctor help, you can reach him on his Email: Dragbomianherbalcured77@gmail.com or via whatsapp +2347040843115

    ReplyDelete
  6. I’m very excited to inform everyone that I’m completely cured from HSV1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Valacyclovir, Famciclovir, and some other products and it’s really help during my outbreaks but I totally got cured from HSV1&2 with a strong and active herbal medicine ordered from a powerful herbalist called Dr AGBOMIAN and it completely fought the virus away my nervous system and I tested negative after 14 days of using the herbal medicine. I’m here to let everyone know that herpes virus has a complete cure, I got rid of mine with the help of Dr AGBOMIAN and his herbal exploit. Contact him via email: Dragbomianherbalcured77@gmail.com or WhatsApp him at +2347040843115

    ReplyDelete