SUCCESSFUL MYOCARDIAL REVASCULARIZATION IN A 92-YEAR-OLD FEMALE PATIENT: A CASE REPORT

Abstract

Introduction. Patients with acute myocardial infarction should be treated with early revascularization. Patients over 73 years have a higher risk of infarct-related cardiogenic shock, which is a leading cause of lethality. Unfortunately, little is known about myocardial revascularization care for elderly people in Ukraine. We presented a 92-year-old lady with an acute chest pain case report, which was not revealed by analgesics. Important clinical findings. Coronary angiography revealed thrombotic occlusion of the distal segment of the left anterior descending artery (LAD) and floated thrombus in LAD mid-segment; stenosis of the left circumflex artery (LCx) close to the first obtuse marginal artery (OM1). The main diagnosis. Acute myocardial infarction with ST-segment elevation of the left ventricle anterior wall (anterior-STEMI). Calcific aortic valve disease, severe aortic valve stenosis, significant mitral and tricuspid valve regurgitation, pulmonary hypertension. Heart failure with reduced LVEF (<40%), NYHA class III symptoms. Intervention. The decision was to perform urgent stenting in LAD and balloon angioplasty in LCx. Successful hospital discharge was after 14 days. Conclusions. Take-away lessons: Elderly patients with acute myocardial infarction can be successfully treated in Ukraine. Age and comorbidities are not a contraindication for early myocardial revascularization.