55yrs old male came with c/c of chest pain which rafiates left arm from last 2days. no significant medical history. his B/P 110/70, pulse 84/min. ECG done. please suggest managment



Lbbb with wpw That is why there is no tachycardia

WPW Syndrome U can't dx mi on the base of ecg when wpw Syndrome r there,,,,, Go for Enzymes Echo

Short pr interval p pulmonale St depression in inferiolsteral leads

Treatment for angina depends upon the cause and may include behavior modification, exercise, medication, and surgery. Should the cause be ASHD, medications may be used to help minimize progression of artery narrowing and plaque buildup. Medications can be also be used to decrease the oxygen requirements of the heart and to allow the heart muscle to function more efficiently. Aspirin may be recommended to make platelets less sticky to prevent clot formation and prevent heart attack. Long-acting nitroglycerin medications (Imdur, Nitropaste) may be prescribed to dilate coronary arteries and increase blood flow to the heart muscle. As well, nitroglycerin may be used to abort an episode of angina. In this case it may be taken as a tablet or spray under the tongue. The best treatment for angina is prevention, especially if the cause is ASHD. Lifelong control of blood pressure, cholesterol, and diabetes will help prevent the development of plaque buildup within arteries not only in the heart but also the brain and peripheral arteries as well. Smoking cessation is mandatory.

Classic angina is described as chest pressure that radiates down the arm, into the neck or jaw and is associated with shortness of breath and sweating. However, patients may use different words to describe the pain, including pain, heaviness, tightness, ache, and fullness. The location may or may not be in the chest; instead it may be described in the upper abdomen, back, arms, shoulder, or neck. Typical angina symptoms should be made worse with activity and should resolve or get better with rest. Angina may not have any pain and instead may present as shortness of breath with exercise, malaise, fatigue, or weakness. Patients with diabetes have an altered sensation of pain and may have markedly atypical symptoms. Women may not have the same angina constellation of symptoms as men. What causes angina? The heart gets its blood supply from coronary arteries that branch off the aorta just as it leaves the heart. The coronary arteries run along the surface of the heart, branching into smaller and smaller blood vessels as they supple each muscle cell of the heart. The most common reason a patient complains of angina is because of narrowed coronary arteries caused by atherosclerotic heart disease (ASHD). Cholesterol plaque gradually builds on the inner lining of a coronary artery, narrowing its diameter and decreasing the amount of blood that can flow past the blockage. If the heart is asked to do more work and pump harder and faster, enough oxygen may not be able to be delivered beyond the blockage to meet the energy demand of the myocardium and this can cause the symptoms of angina to occur.

Angina (angina pectoris) describes the pain, discomfort, ache, or other associated symptoms that occur when blood flow to heart muscle cells is not enough to meet its energy needs. The classic description of angina is a crushing pain, heaviness or pressure that radiates across the chest, sometimes down the arm, into the neck, jaw or teeth, or into the back. It may be associated with shortness of breath, nausea, vomiting, sweating, and weakness. Many people do not use pain as a description for angina, instead describing the sensation as a fullness, tightness, burning, squeezing, or ache. The discomfort may be felt in the upper abdomen, between the shoulders, or in the back. The pain may be felt just in an arm, right, left or both, and may or may not be associated with other symptoms.

Prevention You can help prevent angina by making the same lifestyle changes that might improve your symptoms if already have angina. These include: Quitting smoking. Monitoring and controlling other health conditions, such as high blood pressure, high cholesterol and diabetes. Eating a healthy diet and maintaining a healthy weight. Increasing your physical activity . Aim for 150 minutes of moderate activity each week. Plus, it's recommended that you get 10 minutes of strength training twice a week and to stretch three times a week for five to 10 minutes each time. Reducing your stress level. Limiting alcohol consumption to two drinks or fewer a day for men, and one drink a day or less for women. Getting an annual flu shot to avoid heart complications from the virus

Angina is a type of chest pain caused by reduced blood flow to the heart. Angina is a symptom of coronary artery disease. Angina, also called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms say angina feels like a vise squeezing their chest or a heavy weight lying on their chest. Angina may be a new pain that needs to be checked by a doctor, or recurring pain that goes away with treatment Although angina is relatively common, it can still be hard to distinguish from other types of chest pain, such as the discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away. Products & Services Book: Mayo Clinic Healthy Heart for Life! Symptoms Angina symptoms include chest pain and discomfort, possibly described as pressure, squeezing, burning or fullness. You may also have pain in your arms, neck, jaw, shoulder or back. Other symptoms that you may have with angina include: Dizziness Fatigue Nausea Shortness of breath Sweating These symptoms need to be evaluated immediately by a doctor who can determine whether you have stable angina, or unstable angina, which can be a precursor to a heart attack. Stable angina is the most common form of angina. It usually happens when you exert yourself and goes away with rest. For example, pain that comes on when you're walking uphill or in the cold weather may be angina. Characteristics of stable angina Develops when your heart works harder, such as when you exercise or climb stairs Can usually be predicted and the pain is usually similar to previous types of chest pain you've had Lasts a short time, perhaps five minutes or less Disappears sooner if you rest or use your angina medication The severity, duration and type of angina can vary. New or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack. Characteristics of unstable angina (a medical emergency) Occurs even at rest Is a change in your usual pattern of angina Is unexpected Is usually more severe and lasts longer than stable angina, maybe 30 minutes or longer May not disappear with rest or use of angina medication

History s/o angina LBBB

Lbbb Definitely st depression in lead 2 avl v5v6 History looks angina Ecg lead7 8 9 To know posterior mi 2 decho tropi & t Follow up ecg Lipid profile

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