This 64 year old woman presented intoxicated with nausea and vomiting and epigastric pain, with no chest pain. She has a history of a stent, but unknown in which artery. She stopped taking clopidogrel 2 weeks ago because she ran out. Here is the initial ECG; there was no previous ECG for comparison. Comment

58yr,M, known CAD , Post CABG 1.5yrs back , now presented with sudden onset vertigo,Dizziness, Nausea . at ED , BP 220/120 , HR 63 . No signs of LVF. Diagnosis & EMERGENCY MANAGEMENT ??

Dyspnea It is normal with all of us when we exert excessively.. But Dyspnea that is greater than expected with the degree of exertion... is a symptom of disease. Most cases of dyspnea result from asthma, heart failure and myocardial ischemia, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia, or psychogenic disorders.. Below mentioned are the pathological causes of Dyspnea by Organ System…. CARDIO-VASCULAR…     Pulmonary edema Acute valvular disease Myocardial infarction Cardiac tamponade    Heart failure Angina Constrictive pericarditis RESPIRATORY… Acute exacerbations or persistent chronic asthma Acute exacerbation or persistent chronic obstructive lung disease Pulmonary embolism Pneumothorax Pneumonia ARDS Anaphylaxis    COPD Asthma Interstitial lung diseases Pulmonary hypertension Malignancy (tumor related obstructive lesions and lymphangitic spread) Pleural effusions Sleep apnea Foreign body aspiration GASTROINTESTINAL/HEPATIC Acute liver failure and its consequences Abdominal distention of various causes Ascites Portopulmonary hypertension Hepatopulmonary syndrome RENAL CAUSE Acute or chronic renal failure and its consequences HEMATOLOGICAL… Hemorrhage    Anemia NEUROMUSCULAR     High cervical cord lesions Trauma to phrenic nerves    Central apneas Myasthenia gravis Myopathies Amyotrophic lateral sclerosis ENT cause Vocal Cord Dysfunction Laryngeo-tracheal obstruction PSYCHOGENIC  BREATHLESSNESS I hope this list of causes will be HELPFUL to diagnose the aetiology of DYSPNEA…

30yr primi lscs done in govt hospital ,after 5 hrs no urine output ,ARF ,all needfull done ,but useless no response Bp120/50,p100,rr16/min,oxygen saturation 89-90,forcefull breating Pls advice needfull

pt came with Left leg cellulitis..pt has no other specific complaints related to CVS..k/C/of Hypertension ..BP 140/90..