Abstract:
Background. Diabetes mellitus (DM) is a major cardiovascular risk factor associated with
an increased incidence of acute ischemic events, including acute myocardial infarction
(AMI). Chronic hyperglycemia contributes to endothelial dysfunction, systemic
inflammation, and accelerated coronary atherosclerosis. Recent studies have shown that
patients with DM have a 2-4 times higher risk of myocardial infarction compared to the
general population.
Objective(s). We present the clinical case of a patient with diabetes mellitus who developed
an acute myocardial infarction.
Materials and methods. Male, 59 years old, urgently admitted with acute coronary
syndrome (ACS) to the AMI unit of MCH "Holy Trinity". Medical history: type 2 DM for 12
years, hypertension for 18 years, dyslipidemia, obesity, smoker. Investigations included:
ECG, ECHOCG, coronary angiography, chest radiography, cardiac injury biomarkers, glycated
hemoglobin (HbA1c), hematological and biochemical tests.
Results. Complaints: angina pectoris and exertional dyspnea at minimal physical effort,
headache. Clinical findings: regular heart sounds, heart rate (HR) 124 bpm, blood pressure
(BP) 170/95 mmHg, oxygen saturation (SaO₂) 95%. Paraclinical findings: ECG: ST-segment
elevation in leads V2–V5, left ventricular hypertrophy (LVH), incomplete left anterior
fascicular block. Echocardiography: apical hypokinesia, ejection fraction (EF) 45%,
moderate pulmonary hypertension (PH). Coronary angiography: critical 90% stenosis in the
left anterior descending artery (LAD). Creatine phosphokinase-MB (CPK-MB): 25 U/L;
Troponin I: 1.35 ng/ml (positive). HbA1c: 8.7%; blood glucose: 13.2 mmol/L; LDL
cholesterol: 165 mg/dL; HDL cholesterol: 32 mg/dL; triglycerides: 280 mg/dL. Treatment:
The patient underwent percutaneous coronary intervention (PCI) with implantation of a
drug-eluting stent, and was started on beta-blockers, ACE inhibitors, antiplatelet agents,
statins, and antidiabetic therapy.
Conclusion(s). A smoker and hypertensive patient with diabetes mellitus developed acute
myocardial infarction, requiring prompt diagnosis via coronary angiography, which
revealed severe atherosclerotic lesions in the LAD. These were successfully managed by
coronary angioplasty,
Results. ing in a favorable prognosis.
