Key result
A 68-year-old male with STEMI and significant system delays was successfully treated with primary PCI and complex medical therapy including triple antithrombotic therapy for subsequent complications.
Case Report (n=1)
No
Timely diagnosis and good organization of medical services are crucial for successful STEMI care, and complex cases with complications like heart failure and atrial fibrillation can be managed effectively following current guidelines.
Case highlights gray zones in STEMI care per 2017 ESC guidelines; leaves open key management questions for randomized trials.
Introduction: In many aspects of STEMI patient treatment there are the clear guideline according to many scientific evidences from excellent designed and performed large randomized clinical studies. However, there is still some gray zones of knowledge and scientific fields in which exist no answered questions. Case report: Male patient age 68 has been admitted to Cardiology Clinic, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica due to typical chest pain and electrocardiography (ECG) signs of STEMI anterolateral region. The patient is hospitalized in center for PPCI with time delay of 210 minute, dominantly due to no adequate organization of medical service. Immediate after the admission primary percutaneous intervention (PPCI) was performed at distal tip of venous graft for obtuse branch of LCx with drug eluting stent (DES) implantation with the minimum intrahospital time delay. Hospital course was complicated by heart failure, atrial fibrillation, and thrombus in the left ventricle. Conclusion: Timely diagnosis of STEMI and good organization of medical service at all level is the key to successful care, and the prevention of time delay in establishing diagnosis and adequate therapeutic activities remains an imperative in the treatment of patients with STEMI.
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Trajković et al. (2018) conducted a case report in ST-segment elevation myocardial infarction (STEMI) (n=1). Primary percutaneous coronary intervention (PPCI) and complex medical therapy was evaluated on Clinical stabilization and hospital discharge. A 68-year-old male with STEMI and significant system delays was successfully treated with primary PCI and complex medical therapy including triple antithrombotic therapy for subsequent complications.
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