Optimizing Antiplatelet Therapy in Cardiogenic Shock-Case Presentation and Initial Clinical Course, Dr. Michele Esposito

Case Presentation and Initial Clinical Course, Dr. Michele Esposito

Video Transcription

Video Summary

A 73-year-old man with prior triple-vessel CABG and comorbidities presented with chest pain and mildly elevated troponins. Initial cath targeted a severe lesion in a vein graft to the OM, which was treated, but he rapidly deteriorated into cardiogenic shock and cardiac arrest requiring multiple defibrillations and Impella support. Retrospective review revealed a missed large thrombus in the native left coronary system, indicating a likely culprit. Despite stable initial findings, this case highlights the challenge of diagnosing and managing complex coronary anatomy in cardiogenic shock and underscores vigilance for additional lesions beyond obvious graft disease.

Keywords

triple-vessel CABG

cardiogenic shock

vein graft lesion

left coronary thrombus

Impella support