57 year old male presenting with a heart attack
A 57 year old male patient presenting with acute onset chest pain. His electrocardiogram (ECG) showed a heart attack. He was a smoker (20 cigarettes/day) with a history of hypertension (high blood pressure), which was controlled. His cholesterol was within normal limits [total cholesterol = 4.2 mmo/l, HDL (good cholesterol) = 1.01 mmol/l, LDL (bad cholesterol) = 2.7 mmol/l, triglycerides = 1.9 mmol/l, cholesterol/HDL = 4.2). He weighed 97kg with a height of 183cms and a body mass index of 29.
The video file on the left shows a blocked right coronary artery (the cause of his heart attack). To reopen the artery, a wire was inserted and subsequently a stent was implanted. The video file on the right shows the restoration of flow in the artery and a successful outcome.
A 78 year old male patient was reviewed with a history of intermittent dizziness, falls and two collapses. During one of his collapses he sustained a cut to the back of his head which required gluing.
He has a history of mild aortic valve stenosis (narrowing), hypertension, asthma, and hip arthritis. Examination pulse rate 66 beats/minute, BP 110/80 with no significant change in blood pressure after checked at 1 minute and 3 minutes with unsupported standing. Massage of right neck artery for 4 seconds resulted in his heart stopping beating for almost 10 seconds associated with the patient collapsing (ECG 1 and 2). This condition is called carotid hypersensitivity syndrome. He was successfully treated with a pacemaker.