Always Expect the Unexpected - Muhammad Ayyaz Ul-Haq
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A 66-year-old female presented with severe crushing chest pain for 2 hours. An ECG showed ST elevation and she was diagnosed with an anterior STEMI. Due to her aspirin allergy, doctors considered performing percutaneous coronary intervention (PCI) with either balloon angioplasty or a drug-eluting stent. During the procedure, the left coronary artery (LCA) was found to originate from the right coronary artery (RCA), a rare condition. The aberrant LCA was successfully treated with balloon angioplasty and a drug-eluting stent, which the doctors believe to be the first reported case of primary PCI for an aberrant LCA arising from the RCA.
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The arrested heart surgery patient is a unique beast in surgery and critical care. Dr Nikki Stamp gives a whirlwind tour of post cardiac surgery resuscitation. She will discuss how to spot the potential arrest, how to manage it and some special situations to be aware of in this special group of patients
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- 2. History • 66 year female • Severe crushing chest pain – 2 hours • Examination – NAD • ECG – 3mm ST elevation in V1 to V4
- 3. Background history • Treated HTN • CKD stage 3 • Asthma • Allergic to Aspirin (Anaphylaxis)
- 4. Diagnosis & Plan • Anterior STEMI • Emergent PCI • Consider POBA or BIOFREEDOM stent in view of Aspirin allergy? • Loaded with Prasugrel
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- 13. Biofreedom 3.0 x 33mm
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- 21. Thank you