Man with multiple risk factors and acute coronary syndrome

Dr. Andrés R. Pérez Riera
Brazil

Case presentation

53 years-old male sedentary, with coronary artery disease, diabetes mellitus type 2, centripetal obesity grade II (waist circumference 106cm and BMI =36), high blood pressure and familial dysbetalipoproteinemia («Broad beta disease».). He denies vices.

The patient reffer that approximately an hour and a half he feel at rest an opressive retrosternal pain radiating to jaw, accompanied by cold sweating.
The pain had approximately 20 minutes in duration.
Inexpressive physical exam

Questions

What is the ECG/VCG diagnosis?

Which is the appropriate approach?

Presentación del caso

Hombre sedentário, de 53 años de edad con enfermedad arterial coronaria, diabetes mellitus tipo 2, obesidad centrípeta grado II ( IMC=36 circunferencia abdominal de 106cm), hipertensión arterial sistémica y disbetalipoproteinemia familiar (enfermedad beta ancha). Niega vicios.
El paciente refiere que aproximadamente una hora y media atrás sitió un dolor opresivo retroesternal en reposo irradiado a mandíbula y acompañado de sudoración fría. El dolor duró aproximadamente 20 minutos. Examen físico NDN.