Introduction:Primary percutaneous coronary intervention (PCI) has become the more preferable reperfusion strategy for the management of acute ST-segment elevation myocardial infarction (STEMI). This dramatic switch from thrombolytic therapy to primary PCI was the result of several studies conducted in the early 1990s that demonstrated the superiority of primary PCI at achievement of higher rate of TIMI 3 flow (more than 80% in primary PCI compared to 50 % in fibrinolytics) and reducing stroke and reinfarction as well as an absolute reduction in mortality by 2%. The likelihood of pre-discharge positive exercise test is also reduced by primary angioplasty. In hospital where facilities for primary angioplasty are available, it should be considered over fibrinolytics. These benefits were achieved despite a median door-to-balloon time (D2BT) of 120 min in many of the studies. [1][2] Case Report: A 52 years old businessman was admitted with the complains of sudden severe central chest pain for two and half hours, which was compressive in nature, radiates to back and left arm, associated with profuse sweating and nausea. He denied any H/O cough, breathlessness or syncope. He was not hypertensive, non diabetic, non smoker and he had no H/O ischemic heart disease in his first degree relatives.On examinatio7 , he was anxious, pulse 92 beats/min, blood pressure 110/70 mmHg, temperature 98 F, respiratory rate was 18 breaths/min, heart sounds were audible and normal without any added sound, lungs were clear in both side. 12 lead Electrocardiogram showed acute ST elevated myocardial infarction in the anterior leads with frequent premature ventricular ectopic beat in couplet pattern . Cardiac markers revealed CK-MB 165 U/ml and Troponin I was 27 U/ml. Bed side echocardiogram anteroseptal wall hypokinesia with LVEF 50%. Immediately with adequate preparation, patient was sent to Cardiac Cath Lab for Coronary angiogram with the view of intervention, Coronary angiography revealed there is a 100% occlusion in proximal part of Left anterior descending Artery (LAD) just after origin of 1 st Diagonal branch. Other vessels were normal. Immediately intracoronary bolus dose of Glycoprotein IIb/IIIa antagonist (Eptifibatide) was given. Then floppy wire was crossed throw the lesion and a drug eluting stent (DES) was directly diploid in this lesion . Successful Primary PCI in Left AnteriorRevascularization completed with good TIMI 3 flow. The total procedure was uneventful. After procedure patient was shifted to CCU. There was no post procedure complication, patient's chest pain was relieved and he was discharged 4 days after primary PCI.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.