Why is MI very likely (particularly due to LAD occlusion)?
In RBBB, we sometimes see ST depression in V1 and V2, this is called a secondary repolarization abnormality, also we see isoelectric ST segment in V5 and V6 but sometimes very subtle ST elevation in V5 and V6 for the same reason.
In this patient, with RBBB, we don't expect to find ST elevation in V1 and V2, also we don't expect to see ST depression in V6. It means these ST changes are unrelated to the RBBB, so it is primary ST changes due to ischemia.
The ST depression in V6 is actually a reciprocal change of lead V1, which shows ST elevation. Many people don't know that V1 and V6 show reciprocal changes of each other, as they are set on the chest, opposing each other.
This is anterior MI due to LAD occlusion until proven otherwise.
The ST depressions in inferior leads further support anterior MI, as the reciprocal changes of the anterior wall are sometimes seen in inferior leads.
In RBBB, we sometimes see ST depression in V1 and V2, this is called a secondary repolarization abnormality, also we see isoelectric ST segment in V5 and V6 but sometimes very subtle ST elevation in V5 and V6 for the same reason.
In this patient, with RBBB, we don't expect to find ST elevation in V1 and V2, also we don't expect to see ST depression in V6. It means these ST changes are unrelated to the RBBB, so it is primary ST changes due to ischemia.
The ST depression in V6 is actually a reciprocal change of lead V1, which shows ST elevation. Many people don't know that V1 and V6 show reciprocal changes of each other, as they are set on the chest, opposing each other.
This is anterior MI due to LAD occlusion until proven otherwise.
The ST depressions in inferior leads further support anterior MI, as the reciprocal changes of the anterior wall are sometimes seen in inferior leads.
❤12
لدغة العقرب او الافاعي
عادة الي عدنا بالعراق مو سامة متسوي شي
العلاج : الرمين + هايدروكوتيزون
Local analgesic (lidocaine)
ولاهم شي تستثني compartment syndrome
مسكن بسيط
🔴اذا المريض تعبان : امبولتين antivinom داخل 100مل NSخلال ساعة
وابعث PT, aPTT , INR , D dimer
عادة الي عدنا بالعراق مو سامة متسوي شي
العلاج : الرمين + هايدروكوتيزون
Local analgesic (lidocaine)
ولاهم شي تستثني compartment syndrome
مسكن بسيط
🔴اذا المريض تعبان : امبولتين antivinom داخل 100مل NSخلال ساعة
وابعث PT, aPTT , INR , D dimer
❤34
🌀 اكو قاعدتين مهمين جدا في ICU و ER في اختيار ال antiemetic لحالات التقيء :-
✅ Vomiting+ constipation
= Metoclopramide (plasil)
يقلل التقيء و يزود حركة الأمعاء .
✅ Vomiting + diarrhea
= Ondansetron (Zofran)
يقلل التقيء و يقلل حركة الأمعاء .
تقليل حركة الأمعاء في ondansetron و هذا مو indication هو side effect اله اصلا .
✅ Vomiting+ constipation
= Metoclopramide (plasil)
يقلل التقيء و يزود حركة الأمعاء .
✅ Vomiting + diarrhea
= Ondansetron (Zofran)
يقلل التقيء و يقلل حركة الأمعاء .
تقليل حركة الأمعاء في ondansetron و هذا مو indication هو side effect اله اصلا .
❤43
متوفر اشتراكات رقمية بضمان كامل داخل متجرنا
🟩 TOD
🟩Netflix
🟩Chat gpt
🟩 بقية برامج الذكاء الاصطناعي
🟩 يوتيوب بريميوم
🟩 تطبيقات للدراسة
جميع الاشتراكات بضمان كامل وارخص بكثير من الاشتراك الرسمي
القناة بادارة د سجاد
https://t.me/jodystore2
🟩 TOD
🟩Netflix
🟩Chat gpt
🟩 بقية برامج الذكاء الاصطناعي
🟩 يوتيوب بريميوم
🟩 تطبيقات للدراسة
جميع الاشتراكات بضمان كامل وارخص بكثير من الاشتراك الرسمي
القناة بادارة د سجاد
https://t.me/jodystore2
❤3
خطوة بالاتجاه الصحيح و نتأمل بموقف جدي وحازم من نقابة الاطباء لتضمين ابناؤهم الشباب ضمن موازنة ٢٧ و ضمان حقهم بالتعيين المركزي
❤47
This media is not supported in your browser
VIEW IN TELEGRAM
A 72-year-old male presented to the emergency department with severe central chest pain for approximately 10 hours, associated with sweating, nausea, and shortness of breath. The pain started while he was resting but he initially ignored it, thinking it was indigestion.
❤10