STEMI-87

Published: August 4th, 2016

Category: STEMI

Pre-hospital ECG

ZE00008340_20160804_093904

 

  • No obvious ST Elevation diagnostic for STEMI, although the anterior depressions can be consistent with posterior MI
  • STEMI Alert cancelled on arrival to ED
  • Urgent Cath performed given patient history and presentation

 

Cardiac Cath Report

LMCA: short, patent

LAD: Medium-sized, transapical vesse with diffuse disease. Competitive flow in mid LAD segment from LIMA to distal LAD graft. D1 small with severe diffuse disease.

LCX: Medium-sized dominant vessel with mild luminal irregularities. OM1 branch very small with ostial disease. OM2 branch with proximal 90% stenosis (likely culprit) before bifurcation.

RCA: medium-sized, non-dominant vessel with diffuse disease upto 90%, Chronic total occlusion in mid segment.

PLAN:

1. OM branch with obstructive disease however territory supplied by vessel is small and revascularization of this territority will not impact outcome. Recommend medical management.

2. Medical management per CCU team