Yulia Tunitsky-Lifshitz, Adi Braun, Gad Segal
Periprocedural myocardial infarction (MI) remain common despite major technical advances in the field of interventional cardiology and thoracic surgery (1-5). Most of the literature regarding periprocedural MI was written about a decade ago. Attempts to define clinically relevant MI after coronary bypass define a rise of ≥ 10x in cardiac biomarkers as a cutoff in case the preprocedural troponin is known, or ≥70x of normal troponin values (5). Herein, we describe a case report of a woman that came to a rehabilitation center in our hospital after a Coronary Artery Bypass Graft (CABG) was done in another rural hospital, with an elevation of ≥60 x troponin from baseline in the emergency room (ER). The cardiologist that assessed her attributed the rise to remnant myocardial damage and admitted her to an internal ward. Only after another troponin test taken the following day, the diagnosis of type 5 MI was made and an urgent coronary angiography was done, revealing a complete thrombosis of her venous graft.
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