Dr. Narendra Kumar (Internal Medicine) needs a second opinion on this medical case.
A 42 yom presented at 9 in the morning with retrosternal chest pain for 6 hours. He described it as 8/10 intermittent pain which did not resolve on taking medication.
He has no past history of any heart disease.
He has h/o surgery for appendicitis 7 years back.
BP 179/100 mmHg, Respiratory rate 19 b/m, HR 69 beats/minute, Temp 98.1 degree C.
ECG shows ST-segment elevation in II, III, and aVF, V6; and ST depression in aVL and V1-3.
Another ECG showed more prominent ST elevation in II, III, aVF, and V5,6 and ST depression in aVL and V1-3.
Coronary angiography - left anterior descending artery had a thrombosis in the distal segment. Rest everything looked fine.
Opinion on the case?