1 / 29

Shanghai East Hospital Lai, Yan

Shanghai East Hospital Lai, Yan. Dec 2007 Male, 47 years old Have chest uncomfortable for 2 days No chest pain No HP, DM history Not smoking. EKG: II, III, avF lead Q wave with inverted T wave TNT, Ckmb elevated more than twice Echo: inferior wall systolic insufficiency, EF 53%

jenny
Download Presentation

Shanghai East Hospital Lai, Yan

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Shanghai East Hospital Lai, Yan

  2. Dec 2007 • Male, 47 years old • Have chest uncomfortable for 2 days • No chest pain • No HP, DM history • Not smoking

  3. EKG: II, III, avF lead Q wave with inverted T wave • TNT, Ckmb elevated more than twice • Echo: inferior wall systolic insufficiency, EF 53% • Diagnose: Acute inferior myocardial infarction

  4. The patent became a reverent Buddhist • A strict vegetarian • Go to Putuo island every year, pray everyday • Take Aspirin+ Plavix for 1.5 year, after that take Aspirin only • Continue take statins • No symptom at all, until recently, have chest pain for about 15 minutes

  5. EKG: II, III, avF Q wave, no obvious ST wave change • CKMB normal, TNT 0.051ng/ml (normal＜0.01) • So, we do the CAG again……

  6. We decide to do PCI in both LAD and RCA • Guiding: 6F AL 0.75; Wire: Runthrough The patient never stop praying during the whole operation Finally, Buddha heard him…….

  7. Did we make the wrong decision at the first time , Should we put the stent? Or the Buddha is really listening to him ?

  8. Is a specific kind of angina pectoris • It is involved in multiple mechanisms • A comprehensive therapies should be used

  9. endothelial dysfunction; • Smooth muscle calcium hypersensitivity; • Increased autonomic tone; • Genetic susceptibility; • psychological stress

  10. Quit smoking • Calcium channel blocker like diltiazem • Long acting nitrates • Statins • PCI • ICD (life threatening arrhythmias) • Psychological therapy

  11. To give nitrate before make the decision of PCI is very important • Faith healing is also a kind of therapy, so maybe his pray really worked……

More Related