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Comprehensive Therapies for Acute Myocardial Infarction: A Case Study

Explore a case of acute myocardial infarction in a reverent Buddhist patient, discussing diagnostic findings and treatment decisions. Learn about diverse mechanisms of angina pectoris and comprehensive therapy options. Consider the role of faith healing and individual beliefs in healthcare outcomes.

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Comprehensive Therapies for Acute Myocardial Infarction: A Case Study

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  1. Shanghai East Hospital Lai, Yan

  2. Dec 2007 • Male, 47 years old • Have chest uncomfortable for 2 days • No chest pain • No HP, DM history • Not smoking

  3. 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

  4. 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

  5. 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……

  6. 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…….

  7. Did we make the wrong decision at the first time , Should we put the stent? Or the Buddha is really listening to him ?

  8. Is a specific kind of angina pectoris • It is involved in multiple mechanisms • A comprehensive therapies should be used

  9. endothelial dysfunction; • Smooth muscle calcium hypersensitivity; • Increased autonomic tone; • Genetic susceptibility; • psychological stress

  10. Quit smoking • Calcium channel blocker like diltiazem • Long acting nitrates • Statins • PCI • ICD (life threatening arrhythmias) • Psychological therapy

  11. 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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