45 year old Male
History of Present Illness (HPI):
- Hx of hypertension, dyslipidemia, peripheral vascular disease and 15 year history of type II diabetes.
- Presented with cold-like symptoms including shortness of breath and wheezing for two days.
- ECG revealed ST elevation myocardial infarction.
- Cardiac catheterization revealed:
- Right Coronary Artery: 100% occlusion (chronically) at ostium.
- Left Main: Normal.
- Left Anterior Descending: 100% occlusion.
- Left Circumflex Artery: 90% stenosis mid vessel.
- Left Ventricle: 35% ejection fraction (EF).
- Emergency coronary bypass considered however surgical consultation unavailable. Decision to perform staged percutaneous coronary interventions.