Identification Data-Chest pain

A 40 year old, male, teacher came to the casualty department complaining of chest pain, sudden onset radiating to left shoulder and jaw. He also had a history of being unable to lie flat and shortness of breath after walking for a few steps.


a. State one (1) abnormality of the ST segment shown in the ECG recording
St elevation- lead III, aVF, V3, V4, V5
ST depression- aVL

b. State one (1) other abnormality of the ECG recording shown
Deep Q wave at lead III

c. State the most likely diagnosis
Acute Myocardial Infarction

d. List two (2) other relevant investigations you would do and state your reason

Plasma biochemical marker - to detect any rise in the plasma concentration of enzyme and protein that are normally concentrated within cardiac cells. (in MI- rise in CK-MB, Troponin T and I)

Echocardiography- to check cardiac function and detecting important complication (e.g mural thrombus, cardiac rupture, VSD, mitral regurgitation, pericardial effusion)

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