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Case Sharing: PCI after Escalation from IABP to Impella CP for LMT-ACS with RCA-CTO Complication and Cardiogenic Shock
Dr. Yuya Taguchi, Iwate Medical University
Case
Male in his 70s
Chief complaint
Orbital pain, shortness of breath on exertion
Medical history
Dyslipidemia (diet)
Medication
No regular medication
Coronary risk factors
Dyslipidemia, smoking history (20-40 years old, 40 cigarettes/day)
Current medical history
One week ago, he experienced shortness of breath on exertion. Shock vital, 12-lead ECG showed aVR, V1-V3 ST-segment elevation, simple chest radiograph showed marked pulmonary congestion, ventilator management with endotracheal intubation, CAG after IABP insertion, 3 branches including LMT. The patient was referred to our hospital for multidisciplinary treatment.
Vitals
Blood pressure 83/50mmHg (NA 0.5γ, DOB 5γ),
Pulse 140/min,
SpO2 96% (FiO2 0.6)
12-lead ECG
Sinus rhythm, positive axis, aVR, ST elevation at V1-V3
Simple chest x-ray
Marked p...
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