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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


SHA24/041005