A man in his late 50s was released from a tertiary hospital with an anterior ST-elevation myocardial infarction and cardiogenic shock with onset 6 days before admission. On admission, vital signs showed blood pressure as 98/66 mm Hg while receiving dobutamine and norepinephrine from the referral hospital, a regular heart rate of 90 beats per minute, a respiratory rate of 22 breaths per minute, peripheral oxygen saturation 96% nasal oxygen at 3 L per minute, and a temperature of 36.7° C. Echocardiography showed reduced left ventricle systolic function (estimated ejection fraction, 34%) and hypokinesia of the anteroseptal, anterior, anterolateral, and septal walls. Lung ultrasound demonstrated multiple B-lines in both lung fields. Diagnostic coronary angiography revealed a total occlusion in the left main coronary artery. Percutaneous coronary intervention (PCI) was successful in opening the osteal left main and drug-eluting stents were placed in the left main and left anterior descending arteries.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Mochamad Yusuf Alsagaff, MD, PhD, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga—Dr Soetomo General Hospital, Mayjen Prof Dr Moestopo Street No. 47, Surabaya 60132, Indonesia (firstname.lastname@example.org).
Published Online: April 12, 2023. doi:10.1001/jamacardio.2023.0503
Conflict of Interest Disclosures: None reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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