Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of substernal chest pressure radiating to the [jaw/left arm/back], associated with diaphoresis, nausea, and dyspnea. ECG confirms ST-segment elevation in [leads] consistent with STEMI. Angiographic findings reveal multivessel coronary artery disease (CAD) involving [LAD/LCx/RCA] with culprit lesion identified in [vessel]. Patient is hemodynamically [stable/unstable].
Clinical Examination Findings
General: Patient appears [distressed/diaphoretic/pale]. Cardiovascular: Tachycardic/Bradycardic, S1/S2 present, [murmur/gallop/rub] noted. Pulmonary: Bilateral crackles at bases, tachypneic. Extremities: Cool, clammy, pulses [diminished/symmetric], no peripheral edema. Neurological: Alert and oriented x3, no focal deficits.
Treatment Protocol
Immediate management: Dual antiplatelet therapy (DAPT) initiated. Heparin/Bivalirudin bolus administered. Urgent transfer to Cardiac Catheterization Lab for primary PCI of culprit lesion. Staged intervention planned for non-culprit vessels. Beta-blockers, high-intensity statins, and ACE inhibitors initiated as tolerated.