Case 38-1993

Abstract

Presentation of CaseA 70-year-old man was admitted to the hospital for further management of a myocardial infarct.The patient had been well until three days earlier, when substernal pain developed and was accompanied by mild dyspnea, without nausea, vomiting, sweating, or radiation of pain. He was taken to another hospital within 1 1/2 hours, where laboratory studies showed that the urea nitrogen was 47 mg (17 mmol per liter) and the creatinine 2.4 mg per deciliter (210 μmol per liter). An electrocardiogram revealed an evolving anteroseptal myocardial infarct. Nitroglycerin, morphine sulfate, aspirin, atenolol, and streptokinase (1.5 million U by . . .