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Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT CoronaryAngiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
Given the consistency of the clinical profile with typical angina, associated riskfactors, and abnormal ECG findings, a cardiology consult was promptly requested. Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates.
Smith Major Learning Point: The worst riskfactor for a bad outcome in OMI is young age because cardiologists cannot believe that a young person can have an OMI. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc.
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Coronary Angiogram 
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