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Acute occlusion of the LMCA without significant dynamic changes in the ECG: A case report
Huiqi Zhai1, Rong Li2, Xinjun Zhao2
1Department of Cardiovascular Disease, The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Rationale:
Acute myocardial infarction caused by left main coronary artery (LMCA) occlusion is a critical condition with high mortality. However, when it presents with atypical symptoms and lacks dynamic electrocardiogram (ECG) changes, it poses a diagnostic challenge leading to delayed treatment and poor outcomes. This case report aims to highlight the importance of early recognition and intervention in such "double-negative" presentations to improve prognosis and reduce mortality.
Patient Concerns:
A 49-year-old male with no cardiac history presented to the emergency department with abdominal distension for 4 hours after ingesting a large amount of alcohol.
Diagnoses:
Acute complete occlusion of the LMCA.
Intervention:
Percutaneous coronary intervention.
Outcomes:
One Firebird 3.0 × 33 mm (MicroPort company, Shanghai China) stent was successfully implanted in the LMCA, and the stenosis disappeared and blood flow was smooth after the operation.
Lessons:
A typical AMI without dynamic ECG changes requires aggressive diagnostic workup, including early angiography, to prevent fatal outcomes.
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