68 year old Male

History of Present Illness (HPI):

• Hx of tobacco abuse, coronary artery disease and previous MI.
• Multiple stents placed 10 years and again 3 months prior to admission.
• Persistent chest pressure for about three hours.
• ECG revealed ST elevations in leads II, III, and aVF with ST depressions in leads V2 through V5 consistent with acute injury of the inferior and posterior walls of the left ventricle.
• Cardiac catheterization revealed:
  • Right Coronary Artery: 100% mid-occlusion; Small non-dominant vessel.
  • Left Main: Normal.
  • Left Anterior Descending: Patent stents in proximal and mid segments.
  • Left Circumflex (LCX) Artery: 100% occlusion mid vessel within previously deployed stents consistent with stent thrombosis; Dominant vessel.