RESUMO
In acute cardiac care, prompt diagnosis and management is mandatory. The electrocardiogram (ECG) remains a crucial investigation in the management of ischemic heart disease and arrhythmias. A case is discussed, where the ECG changes caused by the Brugada syndrome and those caused by ischemia, aggravated by myocardial bridging, intertwine.
Assuntos
Síndrome de Brugada/diagnóstico , Anomalias dos Vasos Coronários/diagnóstico , Eletrocardiografia , Isquemia Miocárdica/diagnóstico , Adulto , Síndrome de Brugada/fisiopatologia , Anomalias dos Vasos Coronários/fisiopatologia , Diagnóstico Diferencial , Ecocardiografia , Humanos , Masculino , Isquemia Miocárdica/fisiopatologiaRESUMO
Acute occlusion of the left main coronary artery frequently causes cardiogenic shock and, when this occurs with an initial TIMI 0 flow, has an extremely poor prognosis. The use of a bifurcation system has not been described previously in this situation but has advantages that may result in a simpler and quicker solution then other strategies. This case describes a distal LMCA occlusion, 2 weeks post-stenting of the proximal LAD and proximal Cx, where this strategy was successfully used as a bridge to surgery. Such a strategy may be crucially beneficial in this commonly fatal condition.