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Formal Echocardiogram: Normal left ventricular size and wall thickness. had an initial hs-cTnI less than 52 ng/L (a level with a high PPV for Type 1 MI -- OMI or NOMI) Trops peaked at greater than 36,000 ng/L (very large MI of course) Post PCI ECG the next day: Looks like a nearly completed anterior MI, in spite of rapid reperfusion.
She reports that she is now unable to vagal out of her palpitations and is having shortness of breath and dull chestpain. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrialflutter with regular conduction. She had an echocardiogram which was normal. Her initial EKG is below.
This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chestpain and SOB, worsening over days, with orthopnea. Later, he underwent a formal echocardiogram: Very severe left ventricular enlargement (LVED diameter 7.4 The other atrialflutter types are: 1.
Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade.
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