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Background:Epicardial patch defibrillators (EPDs) were commonly implanted in the 1990s for secondary prevention of suddencardiacdeath. This case highlights such a scenario.Case:A 75-year-old female with a history of cardiac arrest 30 years ago presented with shortness of breath and left leg swelling.
Otherwise, no admission of CAD, HLD, or family history of suddencardiacdeath. A second 12 Lead ECG was recorded: This is a testament to the dynamic nature of coronary thrombosis and thrombolysis. He described the pain as “nagging,” and equally not exacerbated by any kind of movement. But the lesion is still active!
No family history of suddencardiacdeath, cardiomyopathy, premature CAD, or other cardiac issues. This may occur as a result of blunt chest trauma or other acute stress that produces a sudden extreme shear force on a coronary artery ( that can result in an intimal tear that leads to intraluminal thrombosis ).
12,16 In 2017, CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) provided proof-of-principle that inflammation inhibition in the absence of lipid lowering can significantly reduce cardiovascular event rates and helped to define the interleukin-1 (IL-1) to IL-6 to CRP pathway as a central target in CV disease.16
Angiography was technically challenging as the patient was receiving CPR, but the cardiologist suspected acute stent thrombosis and initiated cangrelor, although no repeat angiography was able to be obtained. The patient survived the car crash, but upon learning of her husband's death, she deteriorated.
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