Medical Therapy in Acute Myocardial Infarction: A Case Report

Öz

Acute ST elevation myocardial infarction is among the most important causes of cardiac mortality and morbidity. An 80-year-old female patient was referred to our emergency department with chest pain. The patient, who had been diagnosed with ST elevation inferior and right myocardial infarction, received coronary angiography under primary conditions. There was an intense and long thrombus in the right coronary artery. Therefore, the patient was not considered for percutaneous coronary intervention. Glycoprotein IIb/IIIa receptor blockers and tirofiban were added to antiaggregant and anticoagulant therapy. 2 days later, control coronary angiography did not show any signs of residual thrombus and lesions. Coronary reperfusion was achieved successfully with pharmacological treatment without the requirement of mechanical reperfusion. The patient was discharged without complications with further instructions to regulate the medical treatment. In this paper, we aim to present a case which we successfully treated through pharmacological treatment without the need for an invasive intervention.

Key Words: Acute Myocardial Infarction; Thrombus; Tirofiban.

Anahtar Kelimeler

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Abdulmecit Afşin, Jülide Yağmur, MehmetCansel

Öz

Akut ST elevasyonlu miyokard enfarktüsü kardiyak nedenli mortalitenin ve morbiditenin en önemli nedenleri arasında yer almaktadır. 80 yaşında kadın hasta göğüs ağrısı ile acil servisimize sevk edilmişti. Akut ST elevasyonlu inferior ve sağ miyokard enfarktüsü tanısıyla hasta primer şartlarda koroner anjiografiye alındı. Sağ koroner arterde yoğun ve uzun trombüs vardı. Bu nedenle hastaya perkütan koroner girişim düşünülmedi. Rutin antiagregan ve antikoagülan tedaviye bir glikoprotein IIb/IIIa reseptör blokeri olan tirofiban eklendi. 2 gün sonra yapılan kontrol koroner anjiografide rezidü trombüs ve lezyon izlenmedi. Mekanik reperfüzyona gereksinim olmadan, başarılı bir şekilde farmakolojik tedavi ile koroner reperfüzyon sağlandı. Hasta komplikasyonsuz bir şekilde medikal tedavisi düzenlenerek taburcu edildi. İnvaziv girişim yapmadan farmakolojik tedavi ile başarılı şekilde tedavi edilen bir olguyu sunmayı amaçladık

Anahtar Kelimeler

• Akut Miyokard Enfarktüsü, Trombüs, Tirofiban

Kaynakça

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