Case Reports in Medicine (Jan 2012)

Atypical Presentation of Acute Coronary Syndrome-Not ST Elevation: A Case Report

  • Nicola Vitulano,
  • Graziano Riccioni,
  • Antonio Trivisano,
  • Carlo Palumbo,
  • Linda D’aloia,
  • Elena Ricci Barbini,
  • Nino Leone,
  • Miriam Placentino,
  • Silvia Cappetti,
  • Pierluigi Pellegrino,
  • Rocco Perrella,
  • Vincenzo Ferrara,
  • Gaetano Prencipe,
  • Lorenzo Pellegrino,
  • Matteo Melchionda,
  • Matteo Vitulano

DOI
https://doi.org/10.1155/2012/182379
Journal volume & issue
Vol. 2012

Abstract

Read online

We describe the unexpected case of a 70-year-old man, with medical history of ischemic heart disease and surgery for aneurysm of abdominal aorta, who comes to the emergency department complaining of low-back pain without other symptoms or signs of organic failure. After a few hours we see a deterioration of physical conditions with pulmonary oedema, increase of blood pressure, changing in the ECG pattern, and worsening of left ventricular function with progressive increase of biomarkers for myocardial necrosis. So this pain has revealed the premature symptom of an acute coronary syndrome (ACS). After a short time a subsequent cardiac arrest complicates the clinical situation. After resuscitation, the patient undergoes successfully to coronary angiography and performed a percutaneous transluminal coronary angioplasty (PTCA).