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Abstract: Acute ST-segment elevation myocardial infarction is one of the more serious types of acute myocardial infarction, characterized by ST-segment elevation on electrocardiogram. A 76-year-old male patient was troubled by this disease, so he came to our hospital, complaining of sudden onset of chest tightness and wheezing with profuse sweating, and the diagnosis was confirmed after examination. The patient recovered well and his condition was stable.
Basic information】Male, 76 years old
Disease Type】Acute ST-segment elevation myocardial infarction
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of consultation】January 2022
Treatment plan】Surgical treatment (percutaneous coronary intervention) + oral medication (aspirin enteric tablets, clopidogrel sulfate tablets) + infusion medication (heparin sodium injection)
Treatment period】Inpatient treatment for 1 week, review after 1 month, long-term follow-up
Treatment effect] Symptoms improved, stable condition
I. Initial consultation
The patient had sudden onset of chest tightness and wheezing with profuse sweating while resting in bed, and felt panicky without relief, without other uncomfortable symptoms. Since the onset of the disease, the patient had a clear consciousness, poor mental health, did not eat and drink, and in the past 1 week, he could eat and sleep at night, his urine and stool were normal, and there was no significant change in weight.
II. Treatment history
After the patient was admitted to the hospital, myocardial injury markers such as troponin and serum enzymology were examined, and the results showed that their values were significantly higher than normal. After communication with the patient and his family, a percutaneous coronary intervention plan was determined. The patient’s skin was punctured on the surface of the radial artery, an arterial sheath was placed and then heparin sodium injection was injected through the lateral wall of the sheath. The catheter was pushed to the base of the coronary sinus under the guidance of a guidewire, which allowed the guidewire to enter the geniculate branches of the coronary artery, the stenosis was explored and the balloon was dilated and the stent was placed, and the patient was sent back to the ward after the procedure. The patient was instructed to take aspirin enteric tablets and clopidogrel hydrogen sulfate tablets. After 1 week, the patient recovered well and could be arranged to be discharged from the hospital for convalescence.
III. Treatment effect
The patient had chest tightness and breathlessness with profuse sweating and panic that could not be relieved before treatment. After admission for percutaneous coronary intervention, coronary angiography was performed, which showed a stenosis of <20%. After 1 week of hospitalization, troponin and serum enzymes were checked again, and their results fell back to the normal range. The patient did not have other uncomfortable symptoms during hospitalization, and felt that his symptoms were relieved, so he was discharged from the hospital. After 1 month of discharge, the patient returned to the hospital for follow-up. If there is any discomfort, he should seek medical attention promptly and continue to take aspirin enteric tablets and clopidogrel hydrogen sulfate tablets to prevent postoperative thrombosis.
IV. Precautions
I was sincerely pleased when the patient’s condition improved. Considering that the disease has a tendency to recur, I advised the patient to emphasize that the following points should also be noted in life.
1. Take medication strictly according to medical prescriptions after discharge from the hospital, seek medical advice promptly if there are uncomfortable symptoms, and do not increase or decrease the dosage on your own.
2, after discharge from the hospital to adhere to the need for regular review of electrocardiogram and myocardial injury markers, to understand the recovery of the disease.
3, after the condition is stabilized, physical exercise can be carried out appropriately, it is recommended to choose gymnastics, walking, tai chi and other low-intensity aerobic exercise.
4, the diet is recommended to choose light and easy to digest food, eat more fresh vegetables and fruits, avoid high salt, high fat food.
V. Personal insight
Acute ST-segment elevation myocardial infarction is a disease that occurs on the basis of coronary artery atherosclerosis with insufficient coronary artery blood supply, leading to myocardial ischemic necrosis, with weakness, breathlessness, palpitations and precordial pain as the main symptoms, which can lead to serious consequences such as arrhythmia and heart failure and endanger patients’ lives if not treated in time. Therefore, once the above symptoms appear, you should seek medical attention in time, such as the patient in this case, due to timely consultation, no adverse consequences.