Patient Overview
Patient: Mr. R.K., 45-year-old male
Presentation: Sudden severe chest pain radiating to left arm and jaw
History: Type 2 Diabetes Mellitus (7 years), Hypertension, Dyslipidemia; ex-smoker (quit 2 years ago); sedentary lifestyle
Adjoined Complications
- Type 2 Diabetes Mellitus — poorly controlled (HbA1c 7.9%)
- Hypertension
- Dyslipidemia
- Mild obesity (BMI 29 kg/m²)
Investigations
- ECG: ST-segment elevation in V1–V4 (anterior leads)
- Cardiac biomarkers: Elevated troponin
- Echocardiogram: Anterior wall hypokinesia; LVEF ~40%
Diagnosis
Acute Anterior Wall Myocardial Infarction (STEMI) due to obstruction in the Left Anterior Descending (LAD) artery.
Management
Reperfusion
Emergency percutaneous coronary intervention (PCI) with stent placement.
Medications
- Dual Antiplatelet Therapy: Aspirin + Ticagrelor
- High-intensity statin: Atorvastatin 80 mg daily
- ACE inhibitor: Lisinopril 10–20 mg daily
- Beta-blocker: Metoprolol 25–50 mg twice daily
- Glycemic control: Metformin + SGLT2 inhibitor
Lifestyle Modifications
- Dietary pattern: Low-fat, low-sugar, high-fiber (DASH/Mediterranean)
- Activity: Walking 30 minutes/day, 5 days/week after cardiac clearance
- Avoid smoking, alcohol, and high-salt foods
- Routine monitoring: BP, blood glucose, lipid profile
- Enroll in a structured cardiac rehabilitation program
Precautions & Follow-up
- Strict adherence to all medications, especially dual antiplatelet therapy
- Regular follow-up with cardiologist and diabetologist
- Urgent reporting of new chest pain, breathlessness, or edema
- Weight management and stress reduction practices
References
- ESC Guidelines for the Management of Acute Myocardial Infarction (2023).
- American Diabetes Association — Standards of Care in Diabetes (2025).
- NICE Guideline NG185 — Secondary Prevention in ACS (2023).