Myocardial Infarction

Patient Presentation:
I.P., a 64 year old female presented with new onset chest pain. She reported pain as substernal, and radiating to her shoulders and back. She also complained of shortness of breath and appeared diaphoretic. Patient had a history of CAD, and high cholesterol, although she admits to being non-compliant with her medication. She had attempted taking sublingual nitroglycerin with no relief. Vital Signs: Temp 98.8, BP 144/82, Pulse 88, RR 22.

Differential Diagnoses:
MI, Pulmonary Embolism, Pericarditis

Diagnosis:
A CBC was drawn along with cardiac enzymes. Results showed CBC within normal limits, and troponin of 42.3 mcg/L (normal < 30). 12 lead EKG revealed ST segment elevation. These results lead to the final diagnosis of acute STEMI.

Treatment:
I.P. was taken to the cath lab for angioplasty and stent placement in the left anterior descending artery.

Outcome:
I.P. was transferred to the CCU where she was on continuous telemetry monitoring. She was started on daily aspirin, Plavix®, as well as lisinopril, metoprolol and Lipitor®. She was discharged after 4 days.