Elderly with resp failure, probable COPD
The first ECG QRS is IVCD that is nearly LBBB and nearly with excessively discordant ST elevation, but not enough. Especially given the tachycardia, which tends to exaggerate ST elevation in LBBB.
There is also nearly some concordance of the ST segments in III and aVL.
The second has a slower heart rate and less STE because of it.
The one with T-wave inversion is classic for Takotsubo.
The echo is c/w takotsubo
This is pretty classic takotsubo in a patient with resp failure, but with a little twist in that the first ECG is an LBBB-like QRS.
The estimated left ventricular ejection fraction is 42 %
The estimated pulmonary artery systolic pressure is 60 mmHg + RA pressure.
Decreased left ventricular systolic performance mild .
Left ventricular hypertrophy concentric .
Regional wall motion abnormality-anterolateral .
Regional wall motion abnormality-anterior .
Left ventricular hypertrophy concentric .
Regional wall motion abnormality-apex hypokinetic .
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