TREATMENT OF A PATIENT WITH NSTEMI AND IMPLANTING INTRACORONARY STENT IN RAMUS INTERMEDIUS ARTERY TRIFURCATION LEFT MAIN – CASE REPORT

Valon Asani, Atilla Rexhepi, Halid Sejfuli, Fisnik Demiri

Abstract

Acute coronary syndrome is a term used to describe conditions associated with sudden, reduced blood flow to the heart. One condition associated with acute coronary syndrome is myocardial infarction; when cell death results in damaged or destroyed heart tissue. Even when acute coronary syndrome causes no cell death, the reduced blood flow alters the heart function and indicates a high risk of a heart attack. Acute coronary syndrome causes severe chest pain or discomfort. It is a medical emergency that requires prompt diagnosis and delivery to the emergency cardiologic unit. Treatment goals include improving blood flow, treating complications and preventing future problems. In the Clinical Hospital of Tetovo was admitted a patient with chest pain and discomfort one hour before hospitalization. ECG was performed at admission with no ST segment denivelisations. During the admission hour the Troponine I level was in normal range, after two hours the laboratory was repeated and the second value for troponine was positive. Chest discomfort was still present. The patient underwent Percutaneous coronary intervention (PCI) via radial artery (TRA), after visualization of coronary arteries with Left main artery (LMn) trifurcation and Ramus intermedius artery occlusion in 100%, a stent was implanted. Left main trifurcation is an anatomical variation among the population with an average rate 15-30 %.

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