Hasril Hadis MDM Djamil Hospital

West Sumatera-Indonesia

58-year old gentleman58-year old gentleman chest pain at rest 24 hours earlier. coronary risk factor : smoking & diabetescoronary risk factor : smoking & diabetes

The ECG ST elevation and Pathologic Q II III aVF V7 V9II,III,aVF, V7-V9. The Echo normal LV function (EF=54%) with RWMA over inferior wallwith RWMA over inferior wall. Troponin T positive (1.4 ng/mL )

Coronary angiogram showedCoronary angiogram showedLM normalLAD stenosis 90 95% at Mid LADLAD stenosis 90-95% at Mid LADLCX : stenosis 90% before large OM and sub t t l l i ft OMtotal occlusion after OM. RCA : normal

GC : 6 Fr BL 3 5GC : 6 Fr BL 3.5. GW : Runthrough hypercoat wire. We gave Half dose heparin and EptifibatideWe gave Half dose heparin and Eptifibatide

In patient with STEMI not only distalIn patient with STEMI, not only distal embolization might be occur but also retrograde embolizationretrograde embolization.

Stay calm and Thrombus aspiration couldStay calm and Thrombus aspiration could resolve this problem dramatically.