Generated on Feb 19, 2025, 1:51:33 PMgemini-1.5-flash
In August 2024, 52-year-old female patient ST presented with severe chest pain. A dobutamine stress test revealed global changes indicative of significant cardiac stress. The ECG showed ST elevations in leads II, III, and aVF, confirming an inferior STEMI (ST-Elevation Myocardial Infarction). The patient exhibited escalating anxiety, manifested by increased respiratory rate, hyperventilation, intensifying chest pain, and diaphoresis.
The initial suggestion to administer nitroglycerin was challenged due to the suspected right-sided myocardial infarction; nitroglycerin was deemed contraindicated given the risk of hypotension from reduced preload. This highlighted a crucial point in the diagnosis and treatment of right-sided MI. The treatment plan was swiftly revised, prioritizing immediate cardiac catheterization.
Cardiac catheterization revealed a 100% occlusion of the right coronary artery (RCA). A stent was successfully deployed, restoring blood flow and stabilizing the patient's condition. Post-procedure, the patient received care and education, including discussion of her family history of coronary artery disease (CAD). ST revealed that both her mother and father had undergone coronary artery bypass grafting (CABG), emphasizing a strong genetic predisposition to CAD. This information was shared with her adult children (in their 20s), underscoring the importance of early awareness and preventative measures for them given their increased risk. The patient expressed gratitude for the care and education received. The case underscores the importance of rapid diagnosis and treatment of STEMI, particularly the nuanced considerations in right-sided infarctions, and the significance of family history in risk assessment and preventative care.