Hi everyone…

I wanted to share one interesting case… life-saving procedure done in our Cath lab, Cardiology department…

A 67 Yr old male presented to the Emergency Department with inferior wall MI, with severe hypotension with CHB, inotropic support for blood pressure started in ER, BP maintained patient was shifted to the cath lab,

ECHO Shows

Global hypokinesia, RWMA more in Rca territory, chambers not dilated, severe lv sys dysfunction, EF hardly 25%

CAG Done,
After doing the left system, Pateint went into severe hypotension and became irritable saturation became down and Pateint was intubated.

The patient’s radial artery was dissected while going with the Jr Guiding catcher for RCA angio, then.
The approach was changed to Rt femoral and a temporary pacemaker was kept in the RV.

ANGIO shows TVD

• LAD: osteoprox CTO with timi 2 flow
• LCX: prox 90% stenosis
• RCA: osteal tight lesion 99% with timi 2 flow

PRIMARY PTCA to RCA (Stent size 3x28mm) done
And LAD CTO opened with fielder xt, stented with 2.75x24mm Size

Main Challenge, in this case, was severe hypotension while doing the procedure with high ionotropic support.

The patient is on ionotropic support and ventilator for 3 days and extubated after 3 days… After 6 days… ionotropic support was stopped and BP was maintained without support. Discharged the patient successfully.