Agnes Kristine T Orteza
Makati Medical Center, PhilippinesTitle: Medical management of ST elevation myocardial infarction with coronary artery ectasia and a large intracoronary thrombus
Abstract
Background: Worldwide, Ischemic heart disease is the single most common cause of death. Primary PCI is the preferred reperfusion strategy in patients with STEMI within 12 h of symptom onset, provided it can be performed expeditiously by an experienced team. However, certain factors can affect the success of PCI for some patients. Coronary Artery Ectasia is considered an interventional cardiologist’s dilemma due to its contribution in increasing PCI failure. Another reason affecting PCI success is the presence of an intracoronary thrombus which have been reported in 16.4% of patients with acute coronary syndrome.
Methods: This is a case of a 51-year-old, male, hypertensive, with a family history of Kawasaki Disease who presented at the hospital with jaw pain. He was eventually diagnosed and managed as a case of Acute Coronary Syndrome- ST Elevation Myocardial Infarction and underwent an emergency coronary angiogram which revealed a large intracoronary thrombus in a severely ectatic right coronary artery measuring 8mm in its widest diameter. Administration of a GPIIB/IIIA inhibitor, Tirofiban, was given as bolus then maintained as intravenous drip for 3 cycles along with dual anti platelet therapy, namely aspirin and clopidogrel, was done.
Results: A repeat coronary angiogram was performed after 1 week of medical therapy which revealed an improved TIMI flow from 0 to 2 of the diseased right coronary artery.
Conclusions Primary percutaneous coronary intervention remains as the current standard of care in STEMI but may be challenging due to certain factors that may limit the success of this intervention. Therefore, pursuit of other regimens should also be welcomed in selected cases.
Biography
Agnes Kristine T Orteza is a second year cardiology fellow in training at Makati Medical Center and has completed her residency training at Davao Doctors Hospital. She dreams of becoming vascular specialist after completing her training in cardiology.
Organization Location
1309 Coffeen Avenue, STE 1200, Sheridan, Wyoming 82801, USA
Mail us at
Program Enquiry
cardiacare@scientexconferences.com
General Enquiry
contact@scientexconferences.com
Registration Enquiry
finance@scientexconferences.com
cardiacare@scientexevents.org
Our Social Presence
Call us at
USA : (+1) 914 520 5013