Case & Plan:
Patient Demographics
61 yrs, F
Present Clinical Presentation
Presented with CCS Class III angina and positive stress MPI.
CAD Risk Factors
Controlled hypertension
Controlled hyperlipidemia
Uncontrolled IRDM (retinopathy, neuropathy)
SAQ-7 score:67, Smoker, Obese
Clinical Variables
Mild DOE for long time with EF 54% on echo, small NSTEMI in 12/2021 and cath revealed calcified 2 V CAD, CABG recommended but declined
Medications
Aspirin, Clopidogrel, Losartan, Carvedilol, Bumetanide, ISMN, Atorvastatin, Insulin, Dulaglutide
Cath: Cardiac cath on January 30th 2023 revealed severely calcified 2 V CAD: 95% LAD/D2 bifurcation (1,1,1), 90% LCx-OM1/LPL bifurcation (1,1,1), LVEF 60% and Syntax score 24. Pt underwent successful PCI of LAD/D2 system using RA and 2 Xience SP point DES with Mini-Crush stenting. Pt did well and discharged home next day.
Plan: Now planned for staged PCI of LCx branches using orbital atherectomy and Mini-Crush stenting.
