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.