Dr Naveen K MohanStaff grade Cardiology, D&GRI

Mr. K H

05/09/07• 54 year old male• Not feeling right in eve following

football game in afternoon• Gripping central chest pain 22:30

~ 1 min – recurring every 30 mins

• More frequent – called 999 at 03:00 – pain constant

• Sweaty ++; nausea ++

• Never smoked• Not known diabetic or hypertensive• TC 6.4 mmol/L, Chol:HDL 6.1 Trigs1.0TC 6.4 mmol/L, Chol:HDL 6.1 Trigs1.0• Father died of MI at 86• Father and sister – Hypertension +

DM• Prison officer – off on stress leave

for 2 months

ECG - ambulance

• IV morphine• Tenecteplase• IV heparin

• Admited to DGRI (5am)• Pain free• Pulse 74/min• BP 118/73• SpO2 97% (air)• Heart sounds 1& 2, no murmur• Chest clear

• Further pain 05:40• ST changes V2-4

• D/W cardiology SpR WGI Glasgow – will d/w consultant

• Morphine

VF arrest 06:10VF arrest 06:10 Precordial thump; DC shock 150jPrecordial thump; DC shock 150j

D/W Glasgow WGID/W Glasgow WGI Tirofiban Tirofiban D/W on call consultantD/W on call consultant

• Transferred to Glasgow 06:30

• Further VF 07:00 – DC shock 150j

• WI Glasgow – cathlab – 08:10

• Reviewed in clinic mid Oct• Swimming; Hill walking

• Aspirin, Clopidogrel, Bisoprolol, Ramipril, Atorvastatin, Lansoprazole

• ECG; Echo

Discussion