Shanghai East Hospital Lai, Yan
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Transcript of Shanghai East Hospital Lai, Yan
Shanghai East HospitalLai, Yan
Dec 2007 Male, 47 years old Have chest uncomfortable for 2 days No chest pain No HP, DM history Not smoking
EKG: II, III, avF lead Q wave with inverted T wave
TNT, Ckmb elevated more than twice Echo: inferior wall systolic
insufficiency, EF 53% Diagnose: Acute inferior
myocardial infarction
The patent became a reverent Buddhist A strict vegetarian Go to Putuo island every year, pray
everyday Take Aspirin+ Plavix for 1.5 year, after
that take Aspirin only Continue take statins No symptom at all, until recently, have
chest pain for about 15 minutes
EKG: II, III, avF Q wave, no obvious ST wave change
CKMB normal, TNT 0.051ng/ml (normal < 0.01)
So, we do the CAG again……
We decide to do PCI in both LAD and RCA
Guiding: 6F AL 0.75; Wire: Runthrough
The patient never stop praying during the whole operation
Finally, Buddha heard him…….
Did we make
the wrong decision at
the first time , Should
we put the stent? Or
the Buddha is really
listening to him ?
Is a specific kind of angina pectoris
It is involved in multiple mechanisms
A comprehensive therapies should be
used
endothelial dysfunction;
Smooth muscle calcium
hypersensitivity;
Increased autonomic tone;
Genetic susceptibility;
psychological stress
Quit smoking
Calcium channel blocker like diltiazem
Long acting nitrates
Statins
PCI
ICD (life threatening arrhythmias)
Psychological therapy
To give nitrate before make the decision
of PCI is very important
Faith healing is also a kind of therapy, so
maybe his pray really worked……