Case 1
A 48-year-old male patient applied to the hospital with the complaint of dyspnea and pain in the left arm started suddenly 1 h ago. He informed of excessive alcohol use an hour before the onset of his complaints. The blood pressure was 160/100 mm Hg. Electrocardiography (ECG) showed ST elevation present in V1-V6 with normal sinus ritm. Transthoracic echocardiography (TTE) showed left ventricular ejection fraction (LVEF) 25%. Emergency coronary angiography (CAG): Left main coronary artery (LMCA) and circumflex artery (Cx); normal, right coronary artery (RCA); normal and total occlusion in left anterior descending artery (LAD) before diagonal branch. Predilatation was performed with 2.0×20 mm balloon. 3.5×24 mm drug eluting stent (DES) were implanted. The thrombolysis in myocardial infarction (TIMI) III flow was provided. The patient was discharged on 4. day without complication. The patient had no complaint except mild exertional dyspnea in 24 months follow-up. LVEF was 25%.
Case 2
A 36-year-old female patient applied to the emergency department with the chest pain started 45 min ago. The complaints had started while using alcohol. The blood pressure: 155/90 mm Hg. ECG showed ST elevation present in V1-5 with normal sinus ritm. LVEF was 20% in TTE. Emergency CAG showed RCA and Cx normal, total occlusion in LAD after diagonal. After predilatation with 2.0×15 mm balloon, 3.0×20 DES was implanted. Distal TIMI III flow was provided. The patient was discharged on 4. day without complication. The patient had no angina in 24-month follow-up, but heavy exertional dyspnea. TTE showed LVEF was 25%.
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