A Case Report: Transient ST Elevation Myocardial Infarction After Initial Treatment in Emergency Department

Author : R.R. Aryanti, Z. Choa, R.D. Tureno, S. H. Putra
Upload Date : 19-04-2018

Introduction: Transient ST-segment elevation myocardial infarction (TSTEMI) refers to a condition in which patient with acute chest pain presented with STEMI but then had a complete resolution in ECG recordings. Myocardial infarction is a life threatening event that needed to be treated immediately, therefore timely diagnosis of myocardial infarction event is a key to successful management. Administration of antiplatelet agents, nitrates and oxygen are recommended as an initial treatment in acute myocardial infarction event.1 This case report serves as an evidence in which early diagnosis and initial treatment can possibly cause a complete normalization of STEMI.

Case report: A 49 year-old man with a history of uncontrolled hyperlipidemia and hypertension came with sudden onset of chest pain. The chest pain was left sided and it spread to the left arm. This complaint was accompanied with sweating, nausea, and shortness of breath 1 hour before admission to the emergency department. Symptoms arose when patient woke up in the morning. History of chest pain was recorded 4 years prior to this current attack. Patient was an active smoker for more than 30 years with more than 2 packs of cigarette per day and also an alcoholic man. Patient’s blood pressure was 140/90 mmHg, ECG demonstrated anteroinferolateral ST-segment elevation (Lead II, III, aVF, V3-V6), complete blood count and random blood glucose were normal. Patient was given 2L of oxygen via nasal cannula, 5 mg of isosorbide dinitrate sublingually, loaded with 160 mg of aspirin chewed, and 300 mg of clopidogrel swallowed.

Result: Within one and a half hour after initial treatment was given, symptoms were disappeared. There were also found complete normalization of ST-segment elevation in lead II, III, aVF, V3-V6.

Conclusion: Early diagnosis and early initial treatment are fundamental as management of STEMI, because there is a possibility that STEMI can resolve completely in those who are diagnosed early and received initial treatment.

KEYWORDS : Transient STEMI, Initial Treatment, Emergency Department

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