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Clinical Cardiology Forum. Dr Naveen K Mohan Staff grade Cardiology, D&GRI. ( CCF ). Percutaneous Coronary Intervention. Mr. K H 05/09/07. 54 year old male Not feeling right in eve following football game in afternoon Gripping central chest pain 22:30 ~ 1 min – recurring every 30 mins - PowerPoint PPT Presentation
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Dr Naveen K MohanStaff grade Cardiology, D&GRI
Mr. K H
05/09/07• 54 year old male• Not feeling right in eve following
football game in afternoon• Gripping central chest pain 22:30
~ 1 min – recurring every 30 mins
• More frequent – called 999 at 03:00 – pain constant
• Sweaty ++; nausea ++
• Never smoked• Not known diabetic or hypertensive• TC 6.4 mmol/L, Chol:HDL 6.1 Trigs1.0TC 6.4 mmol/L, Chol:HDL 6.1 Trigs1.0• Father died of MI at 86• Father and sister – Hypertension +
DM• Prison officer – off on stress leave
for 2 months
ECG - ambulance
• IV morphine• Tenecteplase• IV heparin
• Admited to DGRI (5am)• Pain free• Pulse 74/min• BP 118/73• SpO2 97% (air)• Heart sounds 1& 2, no murmur• Chest clear
• Further pain 05:40• ST changes V2-4
• D/W cardiology SpR WGI Glasgow – will d/w consultant
• Morphine
VF arrest 06:10VF arrest 06:10 Precordial thump; DC shock 150jPrecordial thump; DC shock 150j
D/W Glasgow WGID/W Glasgow WGI Tirofiban Tirofiban D/W on call consultantD/W on call consultant
• Transferred to Glasgow 06:30
• Further VF 07:00 – DC shock 150j
• WI Glasgow – cathlab – 08:10
• Reviewed in clinic mid Oct• Swimming; Hill walking
• Aspirin, Clopidogrel, Bisoprolol, Ramipril, Atorvastatin, Lansoprazole
• ECG; Echo
Discussion