학술논문
Navigating Diagnostic Challenges in Acute Coronary Syndrome: A Case of Bezold-Jarisch Reflex and Wellens Pattern.
Document Type
Report
Author
Singh N; Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.; Borkowski P; Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.; Mangeshkar S; Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.; Garg V; Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.; Adal BH; Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.
Source
Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2168-8184
Abstract
Acute coronary syndrome (ACS) presents significant diagnostic challenges, particularly in cases with atypical presentations and complex clinical scenarios. Here, we describe the case of a 59-year-old man who presented with presyncope, bradycardia, hypotension, and later syncope, attributed to the Bezold-Jarisch reflex. Electrocardiographic findings suggested both inferior and anterior wall infarction, with dynamic changes in T-wave morphology further complicating the diagnostic process. Despite a type A Wellens' pattern indicating critical stenosis in the proximal left anterior descending (LAD) artery, coronary angiography revealed a complete thrombotic lesion in the proximal right coronary artery (RCA), necessitating urgent intervention. Despite the Wellens pattern indicating LAD involvement, RCA revascularization took precedence due to immediate thrombotic risk. This case underscores the diagnostic challenges associated with conflicting clinical manifestations in ACS and highlights the importance of individualized management strategies integrating advanced diagnostic modalities to optimize outcomes. Understanding the interplay of complex clinical presentations and employing a nuanced approach to management are crucial in effectively navigating ACS scenarios.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Singh et al.)
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Singh et al.)