Cardiac Cath Report
LMCA: Short with distal 30% stenosis.
LAD: Large-sized, transapical vessel with mid 35% stenosis followed by MLI. The LAD gives off a small-sized, patent D1 vessel.
LCX: Large-sized, dominant vessel occluded at mid-segment, followed by ectatic segment, and then a distal stent which is widely patent. The LCx gives off a small-sized, patent OM1 and large-sized, patent OM2 vessel. The PDA has mild disease.
RCA: Small-sized, non-dominant vessel with proximal 50% stenosis followed by MLI.
Occlusion of mid-LCx with successful stent placement
- 40-50% of all myocardial infarctions.
- more favorable prognosis than anterior myocardial infarction
- Up to 40% of patients with an inferior STEMI will have a concomitant right ventricular infarction. These patients may develop severe hypotension in response to nitrates and generally have a worse prognosis.
- Confirmed with Right sided ECG, Elevation in V4R
- Up to 20% of patients with inferior STEMI will develop significant bradycardia due to second- or third-degree AV block. These patients have an increased in-hospital mortality (>20%).
- ECG findings
- ST elevation in leads II, III and aVF
- Reciprocal ST depression in aVL (± lead I)
- RCA (80%): Elevation in III > II, Reciprocal depression in I
- LCx (20%): Elevation in III = II, No reciprocal depression in I