Crossover between low molecular weight heparin and unfractionated heparin in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Clinical case report

Abstract

Objective: Describe of Crossover between low molecular weight heparin (LMWH) and unfractionated heparin (UFH) in patient with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Method: Descriptive study, report clinical case has acute coronary syndrome undergoing percutaneous coronary intervention, the patient was crossover of LMWH and UFH. Results: A patientas female, 75 years old, admitted to Vietnam National Heart Institute on April, 2018. Reason for hospitalizationas left chest pain, shortness of breath. Medical examination showed the patient with acute coronary syndrome by left chest pain, ST segment elevation in V1 and V2, troponin T increased, suggest the Bloked of the Righ coronary artery (RCA) is the main cause. The result of scan of coronary arteries through radial artery was showed that RCA II is 80% blocked, RCA III is 99% blocked with blood clots. Left anterior descending (LAD) is completely bloked. LCX I is 95% bloked. Beside, collateral circulation is developed, which helps to nurture normal function of left heart muscles. We were conducted to the first PCI for two stent at RCA II and RCA III, the second PCI for the one stent at LCX I. We used crossover between LMW and UFH during PCI, undergoing two times PCI, the patient were conscious and no chest pain, estimate for the LAD by CTO-PCI method on the next time. Conclusion: Crossover between LMWH and UFH in patient with acute coronary syndrome undergoing percutaneous coronary intervention can make safe and more effective.