Acute Myocardial Infarction Caused Sudden Chest Pain and Shortness of Breath in a 76-Year-Old Man
Acute ST-segment elevation myocardial infarction (STEMI) is a severe type of heart attack characterized by ST-segment elevation on an electrocardiogram (ECG). A 76-year-old male experienced sudden chest discomfort and shortness of breath accompanied by heavy sweating. He sought medical attention at our hospital and was diagnosed with STEMI. After undergoing percutaneous coronary intervention (PCI) and receiving medications such as aspirin enteric-coated tablets and clopidogrel bisulfate tablets, the patient showed significant improvement and his condition stabilized.
Patient Profile
Basic Information
- Gender: Male
- Age: 76 years old
- Medical Condition: Acute ST-segment elevation myocardial infarction
- Hospital: First Affiliated Hospital of Xi'an Jiaotong University
- Visit Date: January 2022
Treatment Plan
- Emergency PCI procedure
- Administration of aspirin and clopidogrel
- Intravenous heparin therapy
Recovery Timeline
- One-week hospitalization
- Follow-up appointment after one month
- Ongoing long-term monitoring
Outcome
- Significant symptom relief
- Stable condition post-treatment
Initial Presentation
The patient suddenly experienced chest tightness and difficulty breathing while resting, along with heavy sweating and palpitations. These symptoms persisted without improvement, prompting him to rush to our emergency department by private vehicle. An ECG revealed sinus rhythm with ST-segment elevation ≥ 0.3 mV in leads V1–V4. He was diagnosed with acute ST-segment elevation myocardial infarction and admitted for urgent treatment. Upon admission, he was conscious but fatigued, had not eaten recently, and showed no significant changes in weight or other vital signs.
Treatment Process
Blood tests confirmed elevated cardiac biomarkers, including troponin and serum enzymes, indicating significant heart damage. After discussing treatment options with the patient and his family, we proceeded with percutaneous coronary intervention. Using radial artery access, a catheter was guided through the coronary arteries to locate and treat the blockage. A balloon was used to widen the narrowed artery, followed by stent placement to restore blood flow. Post-procedure, the patient was prescribed aspirin and clopidogrel. He recovered well within a week and was discharged with instructions for continued care.
Post-Treatment Evaluation
Prior to treatment, the patient had persistent chest discomfort, sweating, and palpitations. Following PCI, coronary angiography showed less than 20% vessel narrowing. Repeat blood tests revealed normalized cardiac enzyme levels. During hospitalization, he experienced no further complications and reported significant symptom relief. At the one-month follow-up, he remained stable and continued his prescribed medications to prevent post-procedural thrombosis.
Post-Discharge Care and Recommendations
While I was pleased with the patient's recovery, it's important to emphasize that STEMI can recur. I advised him to follow these guidelines for long-term heart health:
- Medication Compliance: Continue prescribed medications and consult a physician before making any dosage changes.
- Regular Monitoring: Schedule routine ECGs and blood tests to monitor cardiac health.
- Physical Activity: Engage in low-impact aerobic exercises like walking, yoga, or tai chi once medically cleared.
- Nutrition: Follow a heart-healthy diet rich in fruits and vegetables, and avoid high-fat, high-salt foods.
Clinical Insights
Acute ST-segment elevation myocardial infarction is a life-threatening condition caused by sudden blockage in a coronary artery due to atherosclerosis. It leads to myocardial ischemia and tissue damage. Common symptoms include chest pain, shortness of breath, fatigue, and palpitations. Without prompt treatment, complications such as arrhythmias and heart failure may occur, increasing the risk of mortality. This case highlights the importance of timely medical intervention. Early diagnosis and treatment significantly improve outcomes and reduce the risk of long-term complications.