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Case Presentation:
The Patient is a 28 year old Male with chief complaint of Chest Pain which started at 9:00am that day. The
Patient refers that he had a sudden onset of Central Chest Pain (6/10) along with 2 episodes of Vomiting.
He went to a private Institution where a troponin assay was done (11:00 am) which came back negative. Patient
was referred to GMPH and at the time of presentation to A/E had no complaints
He has no previous medical or surgical history. He refers his
mother died of a Myocardial Infraction some years ago.
Physical Examination was unremarkable.
Pertinent Data:
INVESTIGATION
ECG Echo
• ST segment elevation in leads V2, V3, AVF • No Structural Abnormalities
• Sinus Tachycardia
Blood Test
Cardiac Markers • Leukocytosis
• Troponin = 65 ng/dL ( 20:35hrs) • Elevated ESR/CRP
DIAGNOSIS
Management
• Immediate emergency reperfusion therapy has no demonstrable benefit in patients with non-ST segment
elevation MI and thrombolytic therapy may be harmful.
• In ST segment elevation acute coronary syndrome; Immediate reperfusion therapy restores coronary artery
patency, preserves left ventricular function and improves survival.
Management (Long Term Therapy)
This Patient suffered an Inferior STEMI and was effectively managed in ICU with the following medication:
• Atorvostatin 80mg PO Nocte
• Aspirin 81mg PO OD
• Clopidigrel 75mg PO OD
• Inj Heperin 17000 U Sc BD
• O2 via F/M PRN
• GTN Po SL PRN
• Inj Morphine 5mg IV PRN