A 21-year-old patient with acute myardical infarction Beijing Anzhen Hospital Capital Medical University Cui song Zhu Xiao-ling.

Slides:



Advertisements
Similar presentations
Ischaemic Heart Disease- Implications of Gender Dr Kaye Birks School of Rural Health Monash University Australia Gender Competency Training for Medical.
Advertisements

Update on the Medical Management of Acute Coronary Syndrome.
British Cardiac Intervention Society Risk Assessment In Acute Coronary Syndromes Dr David Newby BHF Senior Lecturer in Cardiology Associate Director of.
Chronic stable angina Dr Taban Internist & cardiologist.
Review cases 14-Apr SA is a 47 years old male who developed crushing substernal chest pain around 10 pm, he didn’t went to the hospital, in the.
Management & Nursing Care of Patient with Coronary Artery Diseases Myocardial Infarction)) Dr. Walaa Nasr Lecturer of Adult Nursing Second year Second.
Chest Pain Dr. Shamim Nassrally BSc (Hons) MB ChB MRCP(UK)
Anterior Depressions Angiographic and Clinical Outcomes Among Patients with Acute Coronary Syndromes Presenting with Anterior ST-Segment Depressions C.
 Decide on the correct management of patients with acute coronary syndrome based on the findings of a clinical history, examination and relevant test.
Update on the Medical Management of Acute Coronary Syndrome.
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 53 Management of ST-Elevation Myocardial Infarction.
Shannen Whiddon.  Cardiac tamponade is a condition in which cardiac filling is impeded by an external force.
Clinical Correlations The NYU Internal Medicine Blog A Daily Dose of Medicine
Ischemic Heart Disease (IHD – coronary Heart Disease)
Coronary Artery Disease Angina Pectoris Unstable Angina Variant Angina Joseph D. Lynch, MD.
Chest Pain Dr. Shamim Nassrally BSc (Hons) MB ChB MRCP(London) Clinical Teaching Fellow.
NYU Medical Grand Rounds Clinical Vignette Jennifer Lue, MD PGY-2 9/11/2012 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.
Tuesday Conference Myocardial Infarction Diagnosis and management.
Stable Coronary Artery Disease. Case Presentations.
DR. ZAHOOR 1.  A 50 year old man presents to clinic with a complaint of central chest discomfort of 2 weeks’ duration, occurring after walking for more.
Stress Cardiomyopathy Presented by Brittney Howard, PA-S Advised by Bill Grimes, Dmin, PA-C Presented by Brittney Howard, PA-S Advised by Bill Grimes,
VULNERABLE PLAQUES: Pertinent doubts and solutions in interventional cardiology EuroPCR Paris, 16 May 2006.
Medical Grand Rounds Clinical Vignette October 15 th, 2008 Srikant Duggirala, M.D.
NYU Medical Grand Rounds Clinical Vignette Ramin S Hastings, MD PGY-3 September 8, 2010 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.
Incremental Decrease in Clinical Endpoints Through Aggressive Lipid Lowering (IDEAL) Trial IDEAL Trial Presented at The American Heart Association Scientific.
Acute Myocardial Infarction Joseph D. Lynch, MD. Acute Myocardial Infarction Mechanism Clinical Presentation Diagnosis Management.
Department faculty and hospital therapy of medical faculty and department internal diseases of medical prophylactic faculty. MYOCARDIAL INFARCTION Prof.
Shujuan Cheng,MD; Hongbing Yan,MD Beijing Anzhen Hospital Capital Medical University, Beijing China Argatroban for Severe Thrombocytopnia after Primary.
Acute Heart Failure in Apical Ballooning Syndrome (Takotsubo/Stress Cardiomyopathy) Clinical Correlates and Mayo Clinic Risk Score Malini Madhavan, MBBS;
Non-communicable Disease Coronary Heart Disease
Acute Coronary Syndromes. Learning outcomes To understand the clinical spectrum of coronary disease To recognise different presentations of the disease.
Acute Coronary Syndromes in West Hertfordshire Masood Khan.
MYOCARDIAL INFARCTION. CASE 1 Mr. A: 38 years old He smokes 1 pack of cigarettes per day He has no other past medical history 8 hours ago, he gets sharp.
NYU Medical Grand Rounds Clinical Vignette Jeremy R. Beitler MD, PGY-2 December 16, 2009 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.
Perindopril Remodeling in Elderly with Acute Myocardial Infarction PREAMIPREAMI Presented at The European Society of Cardiology Hot Line Session, September.
CARDIOVASCULAR EFFECTS OF COCAINE 1. TACHYCARDIA + HYPERTENSION 2. NON ISCHAEMIC CHEST PAIN 3. MYOCARDIAL ISCHAEMIA + INFARCTION 4. CORONARY ARTERY ANEURYSM.
Cardiac update for GPs - Chest pain/angina Sanjay Sastry Consultant Cardiologist Royal Bolton Hospital Royal Bolton Hospital Manchester Heart Centre Wigan.
Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for.
M-Guard stent in STEMI patients with high thrombus burden lesions Mahmoud Shabestari Baktash Bayani Ali Eshraghi Bahram Shahri Mashhad University.
Cardiac causes of cardiac arrest
Cardiology Division, Jeju National University Hospital, Jeju, KOREA
Angiotensin converting enzyme inhibitors / angiotensin receptor blockers and contrast induced nephropathy in patients receiving cardiac catheterization:
(CCTA, computed coronary tomography angiography; CMR, cardiac magnetic resonance; ECG, electrocardiogram; Echo, echocardiography; IHD, ischemic heart disease;
Specialist Cardiologist at Sydney. Macquarie University Hospital Cardiology at Macquarie University Hospital, a team of specialist cardiologist, who diagnose.
Acute coronary syndrome
Management of ST-Elevation Myocardial Infarction
The European Society of Cardiology Presented by Dr. Saman Rasoul
CASE HISTORY ISCHEMIC HEART DISEASE
Life after a Cardiovascular Event
PATIENT DEMOGRAPHICS:-
Volume 98, Issue 5, Pages (November 1990)
Unstable Angina and Non–ST Elevation Myocardial Infarction
ECG of a patient with acute inferior myocardial infarction.
Chapter 28 Management of Patients With Coronary Vascular Disorders
CR 10: Myocarditis mimicking an acute coronary syndrome
STEMI-INITIAL PRESENTATION TIMING 2013 ACC/AHA GUIDELINES
Nat. Rev. Cardiol. doi: /nrcardio
Figure 1 PCI strategies in patients with STEMI and multivessel disease
Exercise-Based Cardiac Rehabilitation and Improvements in Cardiorespiratory Fitness: Implications Regarding Patient Benefit  Barry A. Franklin, PhD  Mayo.
The European Society of Cardiology Presented by RJ De Winter
Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From.
A 54 year old man with two hours of chest pain.
European Heart Journal Advance Access
Train-the-Trainer Cases
Train-the-Trainer Cases
Train-the-Trainer Cases
David E. Winchester, MD, David C. Wymer, MD, Roger Y
A model of variation and accelerating factors in the process of acute care chain of patients with STEMI going for primary PCI. PCI, percutaneous coronary.
The Ottawa COPD (chronic obstructive pulmonary disease) Risk Scale (OCRS) is used in the emergency department (ED) to identify patients with acute COPD.
Presentation transcript:

A 21-year-old patient with acute myardical infarction Beijing Anzhen Hospital Capital Medical University Cui song Zhu Xiao-ling

 male, 21y,chest pain of four hour onset  The electrocardiogram : ST-segment elevation in the leads I 、 avL and V1-V6  The cardiac enzyme levels  CK1793U/L,CK-MB212ng/ml,cTnI30.29ng/ml General information

 Echocardiography : anterior-lateral hypokinesia  blood pressure : 120/85 mmHg, HR:78 beats/min  Heart sounds were normal without a gallop sound or significant murmur.  no cardiac risk factors for coronary artery disease  consistent with acute anterior-lateral myocardial infarction

 appropriate treatment was instituted including low-dose aspirin 300mg,100mg,qd  loading-dose clopidogrel 300mg,75mg,qd  5%GS100ml+Diltiazem 20 mg, ivgtt,st  metoprolol,12.5mg.bid,  5%GS100ml+Isosorbide Dinitrate 30mg,ivgtt  Clexane 60mg,ih,q12h  Enalapril,2.5mg , qd  Simvastatin, 10mg , qn  Tirofiban,7ml/h,24h,ivgtt

Admission ECG

2 hours after of admission

Urgent diagnostic coronary angiography

17 days diagnostic coronary angiography

17 days ECG

Question  Do all yang patients with acute mycardical infarction need PCI ?  Statins have been applied?  The pathogenesis of this case?