J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 13, Number 6, June 2022, pages 281-289

ST-Elevation Acute Myocardial Infarction in a Young Man

Figure 1. Electrocardiogram findings. (a) In emergency room. ST elevation in anteroseptal leads (V1-V4) is confirmed together with reciprocal ST depression in inferior leads (II, III, and aVF). (b) One month prior to admission. Normal findings.

Figure 2. Coronary angiogram findings, caudal view. (a) Pre-PCI. A 100% occlusion at segment 6 is confirmed. (b) Post-PCI. Removal of the vascular obstruction together with recanalization, namely 0% stenosis is confirmed. PCI: percutaneous coronary intervention.

Figure 3. Clinical course of the patient. The patient was transported to our hospital and diagnosed as STEMI, afterwards he was performed PCI and admitted on day 1. Afterwards, he was stable during his hospitalization. He was discharged on day 17 and we confirmed that his post-PCI progress was satisfactory on day 31. PCI: percutaneous coronary intervention; CK: creatine kinase; ECG: electrocardiogram.

**Table 1.** Routine Emergency Department Laboratory Examination of the Patient
Parameter (unit)	Measured value	Normal value
White blood cells (× 10³/µL)	6.9	3.9 - 9.7
Neutrophils (%)	60	37 - 72
Lymphocytes (%)	28	25 - 48
Monocytes (%)	5	2 - 12
Eosinophils (%)	6	1 - 9
Basophils (%)	1	0 - 2
Red blood cells (× 10⁶/µL)	5.21	4.3 - 5.67
Platelets (× 10³/µL)	278	153 - 346
Aspartate transaminase (IU/L)	17	5 - 37
Alanine aminotransferase (IU/L)	18	6 - 43
Lactic acid dehydrogenase (U/L)	140	124 - 222
Alkaline phosphatase (U/L)	116	38 - 113
Gamma-glutamyl transpeptidase (IU/L)	29	0 - 75
Total bilirubin (mg/dL)	0.5	0.4 - 1.2
Total protein (g/dL)	7.4	6.5 - 8.5
Albumin (g/dL)	4.5	3.8 - 5.2
Creatine kinase (U/L)	83	57 - 240
Blood urea nitrogen (mg/dL)	24	9 - 21
Creatinine (mg/dL)	1.73	0.6 - 1
Amylase (IU/L)	98	43 - 124
Sodium (mEq/L)	138	135 - 145
Potassium (mEq/L)	3.4	3.5 - 5
Chloride (mEq/L)	104	96 - 107
C-reactive protein (mg/dL)	0.64	0 - 0.29
Plasma glucose (mg/dL)	153	65 - 109
Glycated hemoglobin (NGSP) (%)	5.2	4.6 - 6.2
Low-density lipoprotein cholesterol (mg/dL)	148	70 - 139
High-density lipoprotein cholesterol (mg/dL)	39	40 - 70
Triglyceride (mg/dL)	96	30 - 149
Activated partial thromboplastin time (s)	28	23 - 36
Prothrombin time (international normalized ratio)	1.07	0.85 - 1.15
Fibrinogen (mg/dL)	353	200 - 400
Fibrinogen and fibrin degradation products (µg/mL)	2.5	0 - 10
High-sensitivity troponin T (ng/L)	24	0 - 14
Brain natriuretic peptide (pg/mL)	14.2	0 - 18.4
N-terminal pro-brain natriuretic peptide (pg/mL)	230.1	0 - 125
High-sensitivity cardiac troponin T	24	0 - 14

Table 1. Routine Emergency Department Laboratory Examination of the Patient

Parameter (unit)

Measured value

Normal value

White blood cells (× 10³/µL)

6.9

3.9 - 9.7

Neutrophils (%)

37 - 72

Lymphocytes (%)

25 - 48

Monocytes (%)

2 - 12

Eosinophils (%)

1 - 9

Basophils (%)

0 - 2

Red blood cells (× 10⁶/µL)

5.21

4.3 - 5.67

Platelets (× 10³/µL)

278

153 - 346

Aspartate transaminase (IU/L)

5 - 37

Alanine aminotransferase (IU/L)

6 - 43

Lactic acid dehydrogenase (U/L)

140

124 - 222

Alkaline phosphatase (U/L)

116

38 - 113

Gamma-glutamyl transpeptidase (IU/L)

0 - 75

Total bilirubin (mg/dL)

0.5

0.4 - 1.2

Total protein (g/dL)

7.4

6.5 - 8.5

Albumin (g/dL)

4.5

3.8 - 5.2

Creatine kinase (U/L)

57 - 240

Blood urea nitrogen (mg/dL)

9 - 21

Creatinine (mg/dL)

1.73

0.6 - 1

Amylase (IU/L)

43 - 124

Sodium (mEq/L)

138

135 - 145

Potassium (mEq/L)

3.4

3.5 - 5

Chloride (mEq/L)

104

96 - 107

C-reactive protein (mg/dL)

0.64

0 - 0.29

Plasma glucose (mg/dL)

153

65 - 109

Glycated hemoglobin (NGSP) (%)

5.2

4.6 - 6.2

Low-density lipoprotein cholesterol (mg/dL)

148

70 - 139

High-density lipoprotein cholesterol (mg/dL)

40 - 70

Triglyceride (mg/dL)

30 - 149

Activated partial thromboplastin time (s)

23 - 36

Prothrombin time (international normalized ratio)

1.07

0.85 - 1.15

Fibrinogen (mg/dL)

353

200 - 400

Fibrinogen and fibrin degradation products (µg/mL)

2.5

0 - 10

High-sensitivity troponin T (ng/L)

0 - 14

Brain natriuretic peptide (pg/mL)

14.2

0 - 18.4

N-terminal pro-brain natriuretic peptide (pg/mL)

230.1

0 - 125

High-sensitivity cardiac troponin T

0 - 14