CLINICAL CASE GROUP 2

CLINICAL CASE GROUP 2

de DE LA CALLE ANDRADE LUCILA JAZMIN -
Número de respuestas: 1

Case Summary:

A 58-year-old male with type 2 diabetes mellitus, hypertension, and hyperlipidemia presents to the emergency department with 2 hours of severe chest pain radiating to his left arm. He is sweating profusely and has nausea. His ECG shows ST-segment elevation in leads II, III, and aVF. He has a history of suboptimal glycemic control and is on metformin and atorvastatin.

Key Investigations:

  • ECG: ST-segment elevation in inferior leads (II, III, aVF)
  • Troponin I: Elevated (above the 99th percentile)
  • Echocardiogram: Mild inferior wall hypokinesis

Questions:

  1. Based on the patient's presentation and ECG findings, what is the most likely diagnosis, and what is the significance of the ST-segment elevation?
  2. How does diabetes mellitus influence the pathophysiology of myocardial infarction, and what specific challenges does this pose in management?
  3. What is the role of early reperfusion therapy in the management of acute STEMI, and when should fibrinolytics be considered versus primary PCI?
  4. Discuss the pharmacologic agents you would initiate immediately for this patient upon diagnosis of STEMI.
  5. What are the long-term management strategies for this patient, considering his diabetes and cardiovascular risk factors?

References:

  • American College of Cardiology (ACC) Guidelines, 2023.
  • Fihn, S.D., et al. (2019). "Chronic Coronary Artery Disease: Management." Journal of the American College of Cardiology.

Re: CLINICAL CASE GROUP 2 de CHANCUSIG CASA DAFNE ANAHI -