Myocardial infarction-severe chest pain

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Myocardial Infarction

A 71-year-old woman presented to the emergency department after two hours of severe chest pain. In the preceding three months she had had several episodes of effort-induced angina. Her present pain had arisen without provocation and had not responded to several nitroglycerin tablets. Her medical history was significant for hypertension and adult-onset diabetes. Her heart rate was 120 and blood pressure was 170/96. An ECG showed atrial fibrillation and the diagnosis was acute anterior myocardial infarction. Initial therapy included supplemental oxygen, intravenous nitroglycerin, metoprolol, morphine and heparin. The patient was also given chewable aspirin (160 mg), after which she was transferred to the cardiac catherization laboratory. Coronary angiography showed the left anterior descending (LAD) artery was open at its origin but completely occluded just distal to the first diagonal artery due to a newly formed thrombus.

Reference no: EM133820763

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