An Interesting ECG Case
•75 year old male with history of hypertension developed a burning chest discomfort at 9 PM. Pain was persistent and he eventually fell asleep.
•Woke up at 3 AM with further chest discomfort and called 911.
•No previous symptoms like this. No history of heart attacks.
•ECG shows anterior ST elevation with reciprocal changes in the inferior leads
•Patient received ASA 160 mg, Ticagrelor 180 mg, IV Heparin bolus and was sent directly to the cath lab
•Angiogram showed 100% occlusion in the proximal left anterior descending artery (LAD). The vessel was wired and ballooned to restore flow before 1 drug eluting stent was placed.
•Patient was admitted to the hospital and did well. He was discharged after 3 days. An echo showed LVEF was 50-55% with anterior hypokinesis. He was discharged on ASA, Ticagrelor, Atorvastatin and Ramipril.
Learning points
1 . Time is muscle. Every minute delay in getting treatment during a heart attack, more heart muscle is at risk. The quicker a patient seeks help, the better the chances of protecting the heart and improving recovery.
2 . Dial Don’t Drive. Only 46% of STEMI patients call 911 when they are experiencing chest pain. Calling 911 allows patients to have medical help sooner and can help when there are serious complications like cardiac arrest or arrhythmias.
3 . Symptoms of a heart attack may vary and can be pain, discomfort, burning, pressure, heaviness, etc. Some patients may experience more jaw or back or arm pain. Other patients may not experience any pain but rather severe shortness of breath or feeling cold/cool/clammy or dizzy. It’s important to listen to your body and seek help when needed.
