History:
A 63-year-old with a history of CAD and CABG presented from cardiac
rehabilitation (CR) with acute onset chest pain and shortness of breath.
The patient underwent CR after an acute myocardial infarction one week
ago. During that time, he had a similar presentation with chest pain and
dyspnea and was diagnosed with anteroseptal STEMI. Emergent percutaneous
coronary intervention (PCI) revealed severe stable CAD with patent left
internal mammary artery to left anterior descending artery (LAD),
Saphenous vein grafts (SVG) to obtuse marginal, SVG to the diagonal
artery, and occluded SVG to right coronary artery (RCA). Considering the
ongoing symptoms, a large septal branch was revascularized. The patient
became symptom-free, and ECG normalized. Following his discharge at CR,
he experienced similar symptoms and was sent to the emergency department
for further evaluation.