Case report: a 55-year-old woman with chest pain upon arrival to the emergency department

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Sandeep Nathan

Abstract

The case of a woman with progressive substernal chest pain is described. A 55-year-old woman arrived at the emergency department (ED) with a complaint of progressive substernal chest pain. Her medical history included hypertension and dyslipidemia. Upon arrival to the ED, the patient was free of chest pain. A chest x-ray was essentially unremarkable, and nonspecific inferolateral electrical changes were observed on the initial electrocardiogram (ECG). Initial laboratory test results were unremarkable, with the exception of the cardiac troponin level (0.23 microg/L). However, the patient complained of recurrent chest pain, and an immediate repeat ECG showed fairly significant new ST-segment depression. The patient was diagnosed with non-ST-elevation acute coronary syndrome (ACS). She received 600 mg of clopidogrel, along with i.v nitroglycerin, and subsequently underwent cardiac catheterization. Orthogonal views of the left coronary system clearly showed a high-grade lesion in the middle of the left anterior descending (LAD) artery. Percutaneous coronary intervention (PCI) was performed on the mid-LAD lesion using bivalirudin for procedural anticoagulation, and a 3.0 x 18 mm drug-eluting stent was implanted in the mid-LAD vessel...Continue Reading

References

Feb 8, 2008·The New England Journal of Medicine·Tone SvilaasFelix Zijlstra

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Citations

Oct 22, 2015·Revista gaúcha de enfermagem·Sônia Maria Josino Dos SantosNelson Miguel Galindo Neto
May 14, 2011·International Journal of Speech-language Pathology·Carole Pound

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