Matijasich Paige, Bruss Patrick, Reinhold Gregory, Koppelmann Zachary
University of Toledo College of Medicine and Life Sciences, College of Medicine, Toledo, OH.
ProMedica Monroe Regional Hospital, Department of Emergency Medicine, Monroe, MI.
J Educ Teach Emerg Med. 2023 Apr 30;8(2):V1-V5. doi: 10.21980/J8W06X. eCollection 2023 Apr.
This case report discusses a patient who had subtle EKG abnormalities that were indicative of a pathological amount of coronary artery disease resulting in occlusion of the right coronary artery (RCA) even though ST-elevation criteria for STEMI were not initially present. In the proper clinical setting, focal repolarization abnormalities in conjunction with cardiac risk factors and cardiac symptoms may indicate a high probability of a pathological amount of coronary disease that warrants emergent intervention. We report a case of a 54-year-old male with cardiac risk factors and cardiac symptoms who presented to the emergency department (ED). Initial EKG, while technically abnormal, was not diagnostic. The point of care troponin was elevated at 0.10 ng/mL. Patient ultimately went to the catheterization lab where he was found to have an occlusion of the RCA and left circumflex artery which required stenting.
Electrocardiogram, ECG, cardiology, myocardial infarction.
本病例报告讨论了一名患者,其心电图存在细微异常,提示存在病理性冠状动脉疾病,导致右冠状动脉(RCA)闭塞,尽管最初并不符合ST段抬高型心肌梗死(STEMI)的标准。在适当的临床环境中,局灶性复极异常与心脏危险因素和心脏症状相结合,可能表明存在病理性冠状动脉疾病的高概率,需要紧急干预。我们报告了一例54岁男性患者,有心脏危险因素和心脏症状,前往急诊科就诊。初始心电图虽在技术上异常,但不具有诊断性。即时检测肌钙蛋白升高至0.10 ng/mL。患者最终前往导管室,在那里发现其右冠状动脉和左旋支动脉闭塞,需要进行支架置入。
心电图、心脏病学、心肌梗死。