SHA24/041005

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