NHỒI MÁU CƠ TIM CẤP ST CHÊNH LÊN VÀ THỦNG LOÉT DẠ DÀY TÁ TRÀNG: BÁO CÁO CA LÂM SÀNG

Abstract

Background: ST-segment elevation myocardial infarction and perforated peptic ulcer disease are both emergencies requiring urgent intervention. The patient presented with both emergencies simultaneously a major challenge. Case report: A 61-year-old male presented to the emergency department with a complaint of abdominal pain and angina for 10th hour. An electrocardiogram (ECG) was obtained showing ST-segment elevation in the anterior and inferior leads V2 – V5, II - III - aVF, hs Troponin I: 68886 pg/mL. Computed tomography (CT) of the abdomen and pelvis was subsequently performed, which demonstrated free intraperitoneal air and perforated duodenum. The patient was diagnosed with acute anterior and inferior myocardial infarction for 10th hour with simultaneous perforated duodenal ulcer. The treatment strategy was primary percutaneous coronary intervention first, followed by emergency surgery for perforated duodenal ulcer. After 14 days of hospitalization, the patient recovered well and was discharged. Conclusion: The presence of two life-threatening diagnoses occurring simultaneously in a patient is rare but not unheard of. The establishment of a treatment algorithm use available literature and expert opinion to devise a decision algorithm for future cases in order to provide optimal treatment for these complex cases.