Case Report:
A 30 years old thin male with a clear medical background presented to
the emergency department at Medani Heart Centre (MHC) with central
crushing chest pain with maximum intensity radiated to the left shoulder
and jaw aggravated by movement and improved by rest not associated with
cough or shortness of breath and not improved by ingestion of food or
Antacids. The patient denied fever, change in appetite, diarrhea,
vomiting, change in urine, headache or any other form of neurological
symptoms.
However there was no past history of a similar condition or cardiac
problems. The patient mentioned that he is a heavy smoker and has had
unprotected sexual intercourse many times. The patient denied drinking
alcohol.
On examination the patient looked ill, thin and not pale or jaundiced,
pulse 110 regular good volume, Bp100/60 bilaterally, normal pericardium
findings, clear chest and soft abdomen. ECG showed Significant ST
segment elevation from v1 to v6 and mild elevation in leads 2, 3 and avF
confirmed later by positive serum troponin as Late Extensive ST segment
elevation Myocardial Infarction crushed by aspirin 300mg, clopidogrel
300 mg, bisoprolol 2,5 mg, Enoxaparin inj. weight 1 kg 12 hourly and
the patient was scheduled for urgent Coronary Angiography but during
preparation the ICT for HIV tested positively necessitating confirmation
with ELISA which showed a high viral load of 22.4 AU/ml (normal up to 1
AU/ml). Other tests revealed normal fasting lipid profile, complete
blood count and normal renal function tests with electrolytes.