Case and Plan:
Patient Demographics:
76 yrs, Male
Present Clinical Presentation:
Presented with CCS Class Il angina, post MI
CAD Risk Factors:
Hypertension, Hyperlipidemia, NIDDM LDL: 72, SCr: 1.19, HbA1c: 6.5
Clinical Variables:
CAD s/p PCI for inferior wall STEMI (2/27/2026), EF 30% and then 42% on echo.
Medications:
Aspirin, Atorvastatin, Ticagrelor, Carvedilol, Empagliflozin, Memantine, Metrofmin, Sacubitril-valsartan, Spironolactone
Cath:
Cardiac cath for STEMI on 2/27/2026 @OSH revealed total occlusion of the mid RCA successfully treated with thrombectomy and a DES. Pt has residual CAD; 70-80% distal LMCA lesion, 70% proximal LAD lesion, 80-90% mid LAD lesion, 80-
90% proximal LCX lesion, and 70% RI lesion. A Heart team discussion was performed, and given the intermediate residual SYNTAX score (28), PCI was recommended.
Plan: Now planned for Impella-assisted OCT-guided complex PCI for
LMCA trifurcation and additional lesions.
