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Angiography : LMCA — 90-99% osteal stenosis. LCx — 50-69% stenosis of the 1st marginal branch; with 100% distal LCx occlusion. Cath findings shown above in Dr. Nossen's discussion confirm multi-vessel disease , including 90-99% osteal stenosis of the LMCA. The image shows the impella device in place.
If a patient presents with chest pain and a normal heart rate, or with shockable cardiacarrest, then ischemic appearing ST elevation is STEMI until proven otherwise. I said I think there is a fixed stenosis in the LAD and the tachycardia and stress caused a type 2 STEMI.
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