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Case Study: Acute Myocardial Infarction in a 53-Year-Old Male

This case study presents a 53-year-old male with a history of various medical conditions who experienced chest discomfort while playing tennis. Despite initial treatment, he underwent a percutaneous transluminal coronary angioplasty due to a significant coronary artery blockage, resulting in a successful outcome. The patient recovered well and was discharged eight days post-AMI.

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Case Study: Acute Myocardial Infarction in a 53-Year-Old Male

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  1. Case #1: AMI Presented by amialaniz

  2. Present Illness • 53 year old white male • chest discomfort while playing tennis • became crushing sensation in sternal area and spread to jaw • tennis partner called 911 • arrived at hospital within 30 minutes of onset chest pain

  3. Medical Treatment So Far • nasal cannulae • 5% dextrose in water • 325 mg aspirin • 2 mg intravenous (IV) morphine • sublingual nitroglycerin (SL NTG) tablets • Experienced 0 effects

  4. Predisposed?

  5. Medical History • ulcerative colitis – 22 years • hypertension – 12 years • type 2 diabetes mellitus – 5 years • post acute myocardial infarction • 5 years ago • chronic stable angina – 4 years • benign prostatic hyperplasia • hypertriglyceridemia • adenomatous colonic polyops

  6. Histology: Athersclerotic Plaque Cross Section

  7. Femoral Atherosclerotic Artery

  8. Percutaneous Transluminal Coronary Angioplasty

  9. Familial & Social History • father died from myocardial infarction at age 55 • also had diabetes mellitus • sister, age 52, no reported health issues • brother, age 44, with hypertension • history of cigarette smoking • recurring chest pain with physical activity for the past month

  10. Medications • Amlodipine: 5 mg every morning • Glyburide: 10 mg every morning, 5 mg every night • Aspirin regimen: 325 mg daily • Gemfibrozil: 600 mg twice daily • sulfasalazine: 1.5 grams twice a day • terazosin: 1 mg before bed

  11. In the Hospital

  12. Patient Chart • High Blood Pressure: 160/98 • Temperature: 98.2 • Height: 5’ 10 ½” • Weight: 184 • tachycardia with an occasional premature beat • bibasilar inspiratory crackles with auscultation • bilateral mild pulmonary edema

  13. Pulmonary Edema

  14. Normal vs Edema

  15. Two Days Into His Stay… • stable until he began to experience chest pain again • “emergency angiography revealed a 95% obstruction in the left anterior descending coronary artery” • consistent with completed acute myocardial infarction • percutaneous transluminal coronary angioplasty was successfully performed • successful placement of stent

  16. Happy Ending? • gradually ambulated • physical activity slowly increased • discharged eight days post-AMI

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