Question

Normal ECG 4. Label the first EKG strip using terms like P-wave, T-wave, PR-inte whatever else you can name. a. What is going on in the second EKG strip? b. List the diagnosis, clinical manifestations, basic treatm the space to the right to answer) نه و ن 5. Modifiable risk factor (MRF), non-modifiable risk factor (NME Smoking Hypertension _Cholesterol Menopause Diabetes Family history Ethnicity fouard and backwards effects of Right an نه نه نه نه

Answer 1

4) In the first EKG ( normal EKG),

first wave is P wave

Next complex is QRS complex

Third wave is T wave

The point where the complex ends is the "J "point

a) In the second ECG, the ST segment( flat portion starts from start of S wave / J point and ends at the beginning of T wave) is elevated and also the J point is also elevated

P - Pwave QRS - Q RS Complem T - T wave J - I point ST -ST segment

This is normal ECG

b) The main manifestation seen in the second ECG is ST elevation. ST elevation is a main manifestation of myocardial infarction. It may also called a classic heart attack.

Diagnosis:- ST elevated myocardial infarction

It is a condition in which due to inadequate blood supply, a part of the heart muscle ( myocardium) gets damaged.

Clinical manifestations:-

• Chest pain/ discomfort
• Dyspnea ( shortness of breath )
• Sweating ( diaphoresis)
• Palpitations
• Light headedness
• Nausea/vomiting
• Pallor
• Weakness
• Anxiety

Investigations:-

• ECG
• Cardiac markers
• Glucose
• Electrolytes
• Blood urea nitrogen
• Creatinine

Treatment:-

1. Thrombolytics/ fibronolytics  
   1. It should be done within 30 minutes of patient arrival to hospital
   2. Antiplatelet drug is also used ( aspirin 150- 300mg )
   3. Heparin is used for the prevention of reinfarction and thromboembolism after Acute MI
   4. Thrombolytic drugs :- streptokinase, tenectaplase
2. PCI( percutaneous coronary intervention) is a non surgical procedure done in cardiac catheterization lab used to open the clogged coronary arteries. Also referred to as Angioplasty/stenting
3. CABG ( coronary artery bypass graft) is a surgical procedure. Also called as bypass surgery. It is open heart surgery to restore the normal blood flow to an obstructed coronary artery.

5) modifiable risk factors are which can be modified by making changes in lifestyles. It includes:-

• Smoking
• Hypertension
• Cholesterol
• Obesity
• Sedentary life style
• Diabetes

Non modifiable risk factors are risk factors which cannot be modified by making changes in life style. It includes:-

• Family history
• Ethnicity
• Menopause
• Age
• Gender