A 65-year-old diabetic lady complains of bloating for 3 hours. What is the diagnosis?

Ans. (a) Anterior wall MI.* Baseline artifact is present in lead VI. There is sinus rhythm at a rate of approximately 90 beats/min. The axis is leftward. Intervals are normal.* In addition, there are Q waves and striking ST-segment elevation in the anterior leads V3, V4, and V5 consistent with acute myocardial injury and infarction in this territory. The ischemic changes including ST-segment elevation and Q-wave formation in leads V2 through V4 are present in the anterior leads and most likely represent occlusion of the left anterior descending coronary artery.* There are broad, deep Q waves present in leads II, III, and aVF consistent with inferior myocardial infarction of undetermined age.* Takotsubo cardiomyopathy or broken heart syndrome is due to catecholamine toxicity and is characterised by bal- looning of the apex of the heart.