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1、Case Report,Shengjing Hospital of China Medical UniversityWenyue Pang,Patient name:PanXX,Men,64 years oldWas hospitalized with the chief complaint“remittent chest pain for 5 years with attenuation for 1 week”.Past history:hypertension for 7 years.Smoke 20 cigarettes per day for 30 years.Physical exa
2、mination:BP150/95mmHg，the cardiac boarder enlarged to the left and lower.HR 72 bpm,without cardiac murmur.,Clinic Data,Clinic Data,ECG：Leads V1-V5 ST segments depressed for 0.05mV；PDE：LV=57.4mm；EF=61%；Clinical diagnosis:1.ACS 2.Hypertension grade 3.,Coronary Angiography,Coronary Angiography,Coronary
3、 Angiography,Coronary Angiography,In the preparation of right coronary angiography,before angiographic catheter reached the orifice of the right coronary artery,the patient became:BP depression,from 135/85 mmHg to 80/40 mmHg in 30 seconds.No obvious changes of HRNo obvious changes was observed in th
4、e leads of electrocardiography(ECG)monitoring.The patient said chest skin itch,without chest pain.,Our consideration,Pressure monitoring pathway leakage?contrast media hypersensitivity？Vagal reflex?Occlusion of left main coronary artery？,The patients HR dropped to 35 bpm.Chest pain onsetConsideratio
5、n:acute left major occlusion,Management,XB3.5 Catheter was emergently sent in,approving the 100%occlusion of LM body part.Regret:no video made,Which first?,IABP/Temporary cardiac pacing,then PCIFirst PCI,then.First Drug,then.Other,3.5*18mm Cypher,IABP,3.0*13 Cypher,PCI治疗四:LCX,右冠造影,Follow up results（14 months）,Ophthalmalgia when movementDiagnosis:angina pectorisManagement:angiography,How to manage?,PCICABGDrugOther,Follow up(24 m),Coronary CT:normal,Thanks,
