Postpericardiotomy and Postmyocardial Infarction Syndrome (8)

Case 3
A 56-yeai^old man was seen in the emergency department of a community hospital on June 6, 1989, because of recurring anterior chest and back pains. The ECG showed QRS and T wave changes compatible with an acute anteroseptal MI. Seventeen days later, the patient was referred to Presbyterian Hospital because of recurring chest pain and strongly abnormal results of a treadmill stress test. ventolin 100 mcg
At the time of hospital admission, the ECG showed evidence of the previous anteroseptal infarction. The chest roentgenogram had a normal cardiac silhouette and normal markings. The cardiac enzyme levels were normal. An echocardiogram showed mild inferior-basilar hypokinesis with normal global left ventricular function and normal cardiac valves; there was no pericardial efiusion. Cardiac catheterization showed normal wall motion with an ejection fraction of 65 percent. There was a 90 percent occlusion of the proximal left anterior descending artery and a total occlusion of the right coronary artery. Good collaterals were noted from the left anterior descending and circumflex arteries. A triple coronary artery bypass operation was performed on June 23, 1989 (17 days following MI), using both internal mammary arteries.

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