Case Presentation

The patient is a 49 year-old female with past medical history ofanxiety and hyperlipidemia who presented to an outside hospitalwith complaints of five hours of substernal chest pain followed bythree episodes of syncope witnessed by her son. At presentationin the emergency department the patient denied any currentchest pain or shortness of breath. She received 325 mg of aspirinen route to the hospital by EMS. Her vital signs were temperature100° Fahrenheit, heart rate 60 beats/minute, blood pressure101/50 mm Hg, respiratory rate 20 breaths/minute, and a pulseoxygenation of 98% on room air. The patient’s EKG showed STelevations in the inferior leads. The patient’s laboratory studieswere: white blood cell (wbc) count 14 B/L, hemoglobin 13.2 g/dL, platelets 153 B/L, CKMB 32 U/L, troponin 8.27 ug/L, andCK 24.5 U/L. The patient was started on intravenous heparinand integrillin drips and transferred to Jefferson for emergentcardiac catheterization.