shanghai east hospital lai, yan
DESCRIPTION
Shanghai East Hospital Lai, Yan. Dec 2007 Male, 47 years old Have chest uncomfortable for 2 days No chest pain No HP, DM history Not smoking. EKG: II, III, avF lead Q wave with inverted T wave TNT, Ckmb elevated more than twice Echo: inferior wall systolic insufficiency, EF 53% - PowerPoint PPT PresentationTRANSCRIPT
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Shanghai East HospitalLai, Yan
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Dec 2007 Male, 47 years old Have chest uncomfortable for 2 days No chest pain No HP, DM history Not smoking
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EKG: II, III, avF lead Q wave with inverted T wave
TNT, Ckmb elevated more than twice Echo: inferior wall systolic
insufficiency, EF 53% Diagnose: Acute inferior
myocardial infarction
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The patent became a reverent Buddhist A strict vegetarian Go to Putuo island every year, pray
everyday Take Aspirin+ Plavix for 1.5 year, after
that take Aspirin only Continue take statins No symptom at all, until recently, have
chest pain for about 15 minutes
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EKG: II, III, avF Q wave, no obvious ST wave change
CKMB normal, TNT 0.051ng/ml (normal < 0.01)
So, we do the CAG again……
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We decide to do PCI in both LAD and RCA
Guiding: 6F AL 0.75; Wire: Runthrough
The patient never stop praying during the whole operation
Finally, Buddha heard him…….
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Did we make
the wrong decision at
the first time , Should
we put the stent? Or
the Buddha is really
listening to him ?
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Is a specific kind of angina pectoris
It is involved in multiple mechanisms
A comprehensive therapies should be
used
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endothelial dysfunction;
Smooth muscle calcium
hypersensitivity;
Increased autonomic tone;
Genetic susceptibility;
psychological stress
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Quit smoking
Calcium channel blocker like diltiazem
Long acting nitrates
Statins
PCI
ICD (life threatening arrhythmias)
Psychological therapy
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To give nitrate before make the decision
of PCI is very important
Faith healing is also a kind of therapy, so
maybe his pray really worked……
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