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Case #1: AMI. Presented by ami alaniz. Present Illness. 53 year old white male chest discomfort while playing tennis became crushing sensation in sternal area and spread to jaw tennis partner called 911 arrived at hospital within 30 minutes of onset chest pain. - PowerPoint PPT Presentation
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Case #1: AMIPRESENTED BY AMI ALANIZ
Present Illness 53 year old white male
chest discomfort while playing tennis
became crushing sensation in sternal area and spread to jaw
tennis partner called 911
arrived at hospital within 30 minutes of onset chest pain
Medical Treatment So Faro nasal cannulae
o 5% dextrose in water
o 325 mg aspirin
o 2 mg intravenous (IV) morphine
o sublingual nitroglycerin (SL NTG) tablets
oExperienced 0 effects
Predisposed?
Medical History ulcerative colitis – 22 years
hypertension – 12 years
type 2 diabetes mellitus – 5 years
post acute myocardial infarction 5 years ago
chronic stable angina – 4 years
benign prostatic hyperplasia
hypertriglyceridemia
adenomatous colonic polyops
Histology: Athersclerotic Plaque Cross Section
Femoral Atherosclerotic Artery
Percutaneous Transluminal Coronary Angioplasty
Familial & Social History father died from myocardial infarction at age 55
also had diabetes mellitus
sister, age 52, no reported health issues
brother, age 44, with hypertension
history of cigarette smoking
recurring chest pain with physical activity for the past month
Medications Amlodipine: 5 mg every morning
Glyburide: 10 mg every morning, 5 mg every night
Aspirin regimen: 325 mg daily
Gemfibrozil: 600 mg twice daily
sulfasalazine: 1.5 grams twice a day
terazosin: 1 mg before bed
In the Hospital
Patient Chart High Blood Pressure: 160/98
Temperature: 98.2
Height: 5’ 10 ½”
Weight: 184
tachycardia with an occasional premature beat
bibasilar inspiratory crackles with auscultation
bilateral mild pulmonary edema
Pulmonary Edema
Normal vs Edema
Two Days Into His Stay… stable until he began to experience chest pain again
“emergency angiography revealed a 95% obstruction in the left anterior descending coronary
artery”
consistent with completed acute myocardial infarction
percutaneous transluminal coronary angioplasty was successfully performed
successful placement of stent
Happy Ending?o gradually ambulated
o physical activity slowly increased
o discharged eight days post-AMI