Case and Plan:
Patient Demographics
77 yrs, M
CAD Risk Factors
Hypertension – controlled
NIDDM – uncontralled
Hyperlipidemia – controlled
Present Clinical Presentation
Presented with new onset CCS class Il angina and cath @OSH revealed 3 V CAD
Clinical Variables
No prior cardiac history, echo LVEF 65%
SAQ-7 score: 77, H/o TIA
HbA1c:8.2/ LDL:54/ CRP:1.6/ SCr:0.8, eGFR:99
Medications
Aspirin, ISMN, Metoprolol XL, Losartan, Atorvastatin, Ezetimibe, Metformin, Insulin
Cath: Cath on September 16th 2026 revealed calcific 3 V+LM CAD with syntax score 50 and LVEF 65%. After heart team discussion, CABG was recommended but declined by the pt and referred for high risk PCI. Pt underwent successful RetaDES PCI RCA & did well. Clopidogrel 75mg daily added.
Plan: Now planned for HD-IVUS guided staged complex PCI of calcified LM bifurcation and prox LAD using RotaDES and Mini-crush stunting
