Atrial flutter

Flutter waves.

Atrial fibrillation

Flutter waves. Absent P waves.

ST elevation

ST elevation in anterior leads V1 to V6

ST elevation in anterior leads

Anterior wall myocardial inaction

Glasgow coma scale

1. Eye Opening (E)
a. Spontaneous                                                       4
b. To Speech                                                          3
c. To Pain                                                               2
d. Nil                                                                      1


2. Best Motor Response (M)
a. Spontaneous                                                       6
b. Localises                                                            5
c. Withdraws                                                          4
d. Abnormal flexion                                                3
e. Extensor Response                                             2
f. Nil                                                                      1


3. Best Verbal Response (V)
a. Oriented                                                            5
b. Confused                                                          4
c. Inappropriate words                                          3
d. Incomprehensible sounds                                   2
e. Nil                                                                     1

Brain injury is classified as:

• Severe, with GCS ≤ 8
• Moderate, GCS 9 - 12
• Minor, GCS ≥ 13.

Bradycardia

When the resting heart rate of an adult is less than 60 beats/ minute, the condition is termed as bradycardia. Clinical symptoms generally appear when the heart rate goes below 50 beats/ minute.
In case of atheletes the heart rate may be even below 50 beats/ minute.

Causes-

1. Normal esp in athletes, young healthy individuals
2. Medications - Calcium channel blockers, beta blockers, digitalis, clonidine, amiodarone, anti-arrhythmic drugs.
3. Sick sinus syndrome
4. Vaso vagal response
5. Hypothermia
6. Hypothyroidism
7. Arterioventricular blocks.
8. Myocardial ischaemia involving right coronary artery.
9. increased intracranial pressure (Cushing's reflex)
10. Cardiac infiltrative diseases - amyloidosis, sarcoidosis, hemochromatosis.

Cough - Chronic

Common causes- Post nasal drip, Asthma, Gastroesophageal reflux disease.
Pulmonary infections-

1. Post viral
2. Bronchitis esp in smokers
3. Bronchiectasis
4. Tuberculosis
5. Cystic fibrosis
6. Mycobacterium avium complex
7. pertusis
8. mycoplasma
9. Respiratory synctial virus
10. Parasites- ascaris

Pulmonary non infections-

1. Asthma
2. beta blockers causing asthma
3. chronic obstructive pulmonary disease - COPD
4. Ace inhibitors
5. irritant inhalation- smoking
6. endotracheal lesions- tumors
7. Interstitial lung disease
8. Sarcoidosis
9. Chronic microaspiration

Non pulmonary causes-

1. Gastroesophageal reflux disease
2. Post nasal drip
3. Sinusitis
4. Congestive Cardiac Failure
5. laryngitis
6. Eustachian tube or tympanic membrane infections
7. Psychogenic or habit cough