A 37yrs/male smoker since 15yrs about 3-5 ciggeretts per day with epigastric pain since yesterday evening associated with nausea , burping and fullness of stomach. No h/o chest pain , palpitations , breathlessness ,fever ,cough & cold. No H/O HTN/DM/CAD/CVA/TB/EPILEPSY No family History of cardiac illness or strokes O/E: Vitals stable BP:130/80mm HG PR:90bpm RR:18/min SPo2:98% grbs:113mg/dl CVS:S1S2 ,no gallops ,no murmurs LUNGS: BL NVBS PA:Soft ,mild epigastric tenderness+ CNS:No fnd IMP: ?

Acute Gastristis ?NSTEMI  ADV. ECG  ( 6-30AM ) : WNL In view of cigerret smoking as high risk for CAD .Pateint was kept in ER and repeat ECG done after 25minutes after sending Troponin-I Repeat ECG (7AM ) : ST depressions in anteroseptal leads Trop I : 0.05 ( Elevated ) patient was loaded with aspirin 325mg , clopidogrel 300mhg , Atorvastatin 80mg ,Heparin 4000 IU IV  & Onsensetron 4mg IV As no…