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Dr Naveen K Mohan Staff grade Cardiology, D&GRI

Clinical Cardiology Forum. Dr Naveen K Mohan Staff grade Cardiology, D&GRI. ( CCF ). Percutaneous Coronary Intervention. Mr. K H 05/09/07. 54 year old male Not feeling right in eve following football game in afternoon Gripping central chest pain 22:30 ~ 1 min – recurring every 30 mins

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Dr Naveen K Mohan Staff grade Cardiology, D&GRI

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  1. Clinical Cardiology Forum Dr Naveen K MohanStaff grade Cardiology, D&GRI ( CCF ) Percutaneous Coronary Intervention

  2. Mr. K H 05/09/07 • 54 year old male • Not feeling right in eve following football game in afternoon • Gripping central chest pain 22:30 ~ 1 min – recurring every 30 mins • More frequent – called 999 at 03:00 – pain constant • Sweaty ++; nausea ++

  3. Never smoked • Not known diabetic or hypertensive • TC 6.4 mmol/L, Chol:HDL 6.1 Trigs1.0 • Father died of MI at 86 • Father and sister – Hypertension + DM • Prison officer – off on stress leave for 2 months

  4. ECG - ambulance

  5. IV morphine • Tenecteplase • IV heparin • Admited to DGRI (5am) • Pain free • Pulse 74/min • BP 118/73 • SpO2 97% (air) • Heart sounds 1& 2, no murmur • Chest clear

  6. Further pain 05:40 • ST changes V2-4 • D/W cardiology SpR WGI Glasgow – will d/w consultant • Morphine

  7. VF arrest 06:10 • Precordial thump; DC shock 150j • D/W Glasgow WGI • Tirofiban • D/W on call consultant

  8. Transferred to Glasgow 06:30 • Further VF 07:00 – DC shock 150j • WI Glasgow – cathlab – 08:10

  9. Reviewed in clinic mid Oct • Swimming; Hill walking • Aspirin, Clopidogrel, Bisoprolol, Ramipril, Atorvastatin, Lansoprazole • ECG; Echo

  10. Discussion

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