45 year old Male

History of Present Illness (HPI):

  • Hx of hypertension, dyslipidemia, peripheral vascular disease and 15 year history of type II diabetes.
  • Presented with cold-like symptoms including shortness of breath and wheezing for two days.
  • ECG revealed ST elevation myocardial infarction.
  • Cardiac catheterization revealed:
    • Right Coronary Artery: 100% occlusion (chronically) at ostium.
    • Left Main: Normal.
    • Left Anterior Descending: 100% occlusion.
    • Left Circumflex Artery: 90% stenosis mid vessel.
    • Left Ventricle: 35% ejection fraction (EF).
  • Emergency coronary bypass considered however surgical consultation unavailable. Decision to perform staged percutaneous coronary interventions.