Case Presentation
Mohammed Balghith, MD, FACC,FRCPC,FACP Director of Cath Lab King Abdulaziz Cardiac Center National Guard, Riyadh
Case Presentation • 74 y old male patient Known IHD • Presented to ER with main complaint of acute chest pain on Jan -06-2013 • Typical retrosternal chest pain • Radiating to both arms • 2 hrs duration
Case Presentation • • • • • • • •
Previous Admission with NSTEMI Moderate SVD April 2012 Type II DM HTN Smoker Hyperlipidemia Epilepsy Brain meningioma
Case Presentation • • • •
Diagnosis ACS Inferior STEMI by ECG Started on ACS Treatment Protocol in ER Cath Lab activated
Cath Lab • • • • •
Primary PCI for culprit artery Coronary Angiogram Mid RCA 100% occlusion PCI done and 3x28 mm DES deployed Excellent final results
LCA
LCA
RCA with Total occlusion and Clot
RCA with Total occlusion and Clot
RCA after wiring
RCA PTCA
3X28 mm DES
Final Result
RCA
Laboratory •Troponin I = 82 •CKP = 1686 •HDL= 1.2 •LDL= 3.3 •HgbA1C= 12 •FBS= 9.5
Echocardiogram • Ejection Fraction = 55% • Small size inferior WMA with hypokinesis • Mild MR
Thank You