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🩺Liver Function Test

🌧CAUSES OF OEDEMA

🩺𝐒𝐩𝐢𝐤𝐞𝐝 𝐇𝐞𝐥𝐦𝐞𝐭” 𝐒𝐢𝐠𝐧: New ECG Marker of #CCU_SIGN Critical Illness and High Risk of Death ================================= Spiked Helmet Sign (SHS) is ECG marker associated with increased risk of lethal ventricular tachyarrhythmias and sudden cardiac death. SHS formation is attributed to sympathetic hyperactivity, which mediates increased dispersion of ventricular repolarization, leading to marked QT prolongation and macroscopic T-wave alternans. This pattern can be observed in critically ill patients with cardiac or noncardiac conditions. In particular, immediate identification of this ECG abnormality is crucial in recognizing and treating noncardiac conditions in older male patients. 𝙏𝙝𝙞𝙨 𝙥𝙖𝙩𝙩𝙚𝙧𝙣 𝙞𝙨 𝙘𝙝𝙖𝙧𝙖𝙘𝙩𝙚𝙧𝙞𝙯𝙚𝙙 𝙗𝙮 ❣️ • slurring or notching J-point elevation, • subsequent downsloping ST-segment elevation, • wide T(U)-wave inversion in the inferior leads, • suggesting a combination of J-point, elevated ST segment, and T-wave. ECG showed Dome-and-Spike Pattern, Giving the appearance of Pickelhaube, German military spiked helmet introduced in 1842 by Friedrich Wilhelm IV, King of Prussia (Figure). 𝙈𝙚𝙘𝙝𝙖𝙣𝙞𝙨𝙢 Certain pathological conditions can rarely result in Repetitive contraction of the diaphragm that is in concert with the cardiac cycle. Such diaphragmatic contractions may result in Alteration of the ST segment, which is best seen in the inferior leads. 💮 𝙋𝙪𝙡𝙨𝙖𝙩𝙞𝙡𝙚 𝘿𝙞𝙖𝙥𝙝𝙧𝙖𝙜𝙢𝙖𝙩𝙞𝙘 𝙢𝙤𝙩𝙞𝙤𝙣 𝙈𝙚𝙘𝙝𝙖𝙣𝙞𝙨𝙢 —————————————————————— • Direct stimulation of the diaphragm by the inferior wall of the left ventricle or • Triggering of the left leaf of the diaphragm by the left phrenic nerve. • Repetitive Epidermal stretch in association with Nearby pulsatile flow or due to Acute rise in Intrathoracic or Intra-abdominal pressure. 𝘾𝙤𝙣𝙘𝙡𝙪𝙨𝙞𝙤𝙣 The spiked helmet sign is a potential novel ECG marker of a very high risk of impending death, but the prevalence, mechanism, and clinical applicability remain uncertain at this time. Repetitive signals in the ECG that are not generated by cardiac depolarization or repolarization have previously been shown to provide important clues to patients’ clinical conditions and guidance on their treatment. Further experience is needed to determine whether the spiked helmet sign will eventually change clinical management or just remain an electric curiosity.

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🔴Which ECG lead reflects which coronary artery?✅🫀⤵️ 🔹This diagram gives a clear and simple overview of how different parts of the heart, supplied by specific coronary arteries, are reflected in various ECG leads. Understanding this helps in localizing the site of myocardial infarction. 1️⃣ Right Coronary Artery (RCA) supplies the inferior part of the heart and is seen in leads II, III, and aVF. If these leads show ST elevation, it suggests an inferior wall MI. 2️⃣Left Anterior Descending (LAD) artery supplies the front of the heart, including the septum. Leads V1 to V4 correspond to this region. ST elevation here indicates an anterior or septal MI. 3️⃣ Left Circumflex (LCx) artery and its obtuse marginal branches supply the lateral wall. This is reflected in leads I, aVL, V5, and V6, where changes suggest a lateral MI. 4️⃣ Posterior Descending Artery (PDA) supplies the back of the heart. Posterior leads V7–V9 help identify a posterior MI, often associated with ST depression in V1–V3. 5️⃣ Right Ventricular (RV) branches from RCA show up in right-sided leads like V3R and V4R. These leads are especially important in cases of inferior MI to check for RV infarction. @cardiology

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