Case and Plan:
Patient Demographics
71 yrs, Female
Present Clinical Presentation
Presented with progressive chest pain radiating to the back upon exertion and at rest.
CAD Risk Factors
Controlled hypertension, Controlled NIDDM, Hyperlipidemia, GERD, ex-smoker, SAQ-7 Score: 46, LDL: 60, HbA1c: 7.8, SCr: 1.04
Clinical Variables
Positive exercise treadmill test with chest pain.
EF 65% on echo.
Medications
Aspirin, Clopidogrel, Atorbastatin, Amlodipine, Metoprolol, Olmesartan, Sitagliptan, Nitroglycerin
Cath: Cardiac cath on 10/10/2025 @MSH revealed 2V CAD; 90% proximal RCA, 70% calcified distal LM, and 90% calcified proximal LAD and 80% D1 lesions. LVEF 60% and Syntax score 26. Pt underwent successful PCI of proximal RCA using DES and did well.
Plan: Now planned for Imaging-guided PCI for severely calcified LM and
LAD/D1 bifurcation lesions.
