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.
Objective(s). We present the clinical case of a patient (smoker, dyslipidemia, obesity) with
diabetes mellitus who developed an acute myocardial infarction managed by coronary
angioplasty.
Materials and methods. Male, 59 years old, urgently admitted with 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, HbA1c, hematological and
biochemical tests.
Results. Complaints: angina pectoris and exertional dyspnea at physical effort, headache.
Clinical: regular heart sounds, HR 124 bpm, BP 170/95 mmHg, SaO₂ 95%. Paraclinical: ECG:
ST elevation in V2–V5, left ventricular hypertrophy, incomplete left anterior fascicular block.
EchoCG: apical hypokinesia, EF 45%, moderate PH. Coronary angiography: critical 90%
stenosis in LAD. CPK-MB: 25 U/L; Troponin I: 1.35 ng/ml (positive). HbA1c: 8.7%; blood
glucose: 13.2 mmol/L; LDL: 165 mg/dL; HDL: 32 mg/dL; TG: 280 mg/dL. Treatment: PCI
with implantation of a drug-eluting stent, beta-blockers, ACE inhibitors, antiplatelet agents,
statins, 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, resulting in a favorable prognosis.
