Mr. Tran Thanh Kim (63 years old, in Phuoc Hoa, Nha Trang) had all the shortness of breath and breastbone pain completely stopped, eating well after 2 weeks of coronary stent implantation at Vinmec Nha Trang Hospital. He felt as though he had a new life after his severe coronary stenosis, which was accompanied by numerous complex conditions, was fully treated.
Severe heart disease with many complicated diseases
Mr. Kim has had hypertension for many years, type 2 diabetes, chronic kidney disease. He has had dull chest pain for several months now. He visited the doctor, received numerous treatments but the pain persisted and would not go away. What worries him is that the chest pain has increased for the past week or so, more pain behind the sternum, and mild shortness of breath.
Mr. Kim visited Vinmec after being told that it was a hospital with cardiology specialists. Based on the results of CT coronary angiography, echocardiography, and electrocardiogram, he was diagnosed at the same time with many diseases: hypertension, type 2 diabetes, blood lipid disorders, chronic kidney disease and especially ischemic heart disease with common trunk stenosis and three coronary arteries.
“Mr. Kim has a convoluted history of coronary artery disease and several chronic illnesses. Therefore, in order to have the optimal treatment method, we consulted with Cardiologists in Vinmec Health System with leading experts in cardiology in Vietnam” – Master-Doctor. Nguyen Minh Son - cardiologist in Vinmec Nha Trang shared.
According to CT scan results, the patient has complex and diffuse lesions of several coronary arteries, with the most severe being a narrowing of 90% of the lumen diameter - with damage to the left coronary artery, lesions at split position.
It is expected that the procedure would take a long period if a large number of stents and other supporting devices are anticipated to be needed during the intervention. Meanwhile, Mr. Kim with stage 3 chronic kidney disease must limit the amount of contrast dye during the intervention to avoid the risk of worsening renal failure. As a result, this is not only a difficult intervention but also a potential risk for the patient. However, without treatment, chest pain is difficult to manage and the long-term outcome will cause severe heart failure or the patient may experience life-threatening events such as acute myocardial infarction.
Percutaneous coronary intervention
The team decided on percutaneous coronary intervention along with optimal medical treatment pre- and post-intervention: Percutaneous coronary intervention was then carried out after coronary angiography had verified the diagnosis.
The intervention process took 80 minutes but was successful because of meticulous planning and sophisticated equipment such as the most advanced DSA 2-sided angiography device available today. Doctors at Vinmec Nha Trang Hospital and University of Medicine and Pharmacy Hospital in Ho Chi Minh City successfully coordinated to place 2 drug-eluting stents in challenging locations on the anterior interventricular artery branch and the cross branch. After coronary stent implantation, the damaged vascular flow was successfully repaired without any complications.
As a result, right after the intervention, Mr. Kim's chest pain nearly totally disappeared thanks to myocardial reperfusion, and the test parameters remained constant. In particular, the amount of contrast dye has been calculated with extreme precision, so it has no impact on renal activity or function.
Mr. Kim made a full recovery by following the guidance and recommendations of the physician who administered medication following coronary intervention. He felt his body to be relieved and was able to resume his daily activities after just 2 weeks of treatment.
Percutaneous coronary intervention is a method of treating complex cardiovascular diseases, which has been routinely performed by Vinmec Nha Trang Hospital since February 2019. For complicated cases, the hospital actively coordinated telemedicine consultations with Cardiologists throughout the Vinmec Health System, at the same time cooperated with skilled experts from the University of Medicine and Pharmacy in Ho Chi Minh City to early detect disease and optimize treatment for patients.
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