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Insufficient intervention strategies cause death


Patient male, 76 years old, this time because of "paroxysmal chest pain 1 month, increased 11 hours" admission. Patients had no special history, smoking for 30 years, 7 to 8 per day, had quit smoking for 20 years. Patients after admission ECG examination prompted V1 ~ V5 lead ST segment arch up the elevation, emergency myocardial enzyme test prompted troponin (TnT) 3.04 ng / mL. Diagnosis of coronary heart disease, acute anterior myocardial infarction. One hour after admission to receive direct percutaneous coronary intervention (PCI). Coronary angiography results suggest 100% occlusion in the middle of the right coronary artery (RCA). Left end (LM) 30% stenosis, circumcision (LCX) opening 60% narrow, LCX to RCA to provide 3 collateral circulation, left anterior descending branch (LAD) near lesion, the middle 100% occlusion. Analysis of patients with imaging and electrocardiographic findings can be found, RCA occlusion for the old lesions, the infarct-related blood vessels for the LAD. The intervention strategy used in this patient was to treat acute obstructive lesions in the middle of LAD. Due to lack of experience of the surgeon, also taking into account the level of medical expenses for patients, interventional treatment after the patient immediately appeared cardiogenic shock, the heart suddenly stopped. Despite the timely opening of LCX, patients still rescue invalid, and ultimately died. This paper analyzes the causes of treatment errors in this case and summarizes lessons.

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