Document Detail

Aggressive management of acute myocardial infarction: successful outcome in an older patient with cardiogenic shock.
MedLine Citation:
PMID:  17384884     Owner:  NLM     Status:  MEDLINE    
A 71-year-old man was referred to our emergency department presenting with acute inferior and right ventricular myocardial infarction with cardiogenic shock. He developed ventricular fibrillation 80 minutes after arrival. Immediate defibrillation, mechanical ventilatory support with oxygenation, and inotropic agents were instituted. Despite restoration of sinus rhythm, his hypotension persisted. He promptly received intra-aortic balloon pump (IABP) counterpulsation and cardiac catheterisation. Coronary angiography revealed a subtotal occlusion of the left anterior descending coronary artery and complete occlusion of the right coronary artery. Since the right coronary artery was considered to be the infarct-related coronary artery, percutaneous coronary intervention (PCI) was carried out to the right coronary artery only. The patient was extubated and IABP was removed on the second and third admission day, respectively. He was discharged from the hospital eight days later. A second PCI to the left anterior descending coronary artery was performed successfully three weeks later. This case illustrates that in patients with acute myocardial infarction and cardiogenic shock, prompt application of IABP and PCI of the infarct-related coronary artery may be beneficial in reducing the catastrophic morbidity and mortality, especially in older patients.
Y T Tsao; C J Wu; S L Lin; C P Liu; T Tak
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  48     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  350-3     Citation Subset:  IM    
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Intra-Aortic Balloon Pumping*
Myocardial Infarction / therapy*
Shock, Cardiogenic / therapy*

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