Primary PCI in a patient of inferior ST-segment elevation myocardial infarction in the time of severe hyperkalemia: a case report.

This case report describes the management of a middle-aged hypertensive male patient who presented with acute inferior ST-segment elevation myocardial infarction accompanied with severe hyperkalemia. His coronary angiography revealed a thread like right coronary artery along its entire course and normal left coronary artery system with patent coronary stents in the left anterior descending and left circumflex arteries. Subsequent to correction of hyperkalemia with intravenous calcium gluconate and regular insulin the patient underwent primary percutaneous coronary intervention (PPCI) of the right coronary artery with the deployment of a sirolimus eluting stent. The patient received overnight an infusion of tirofiban at half the usual dose between the diagnostic coronary angiogram and PPCI.