Agent ide study: it was reported that in-stent restenosis occurred.On (b)(6) 2017 a 4.00 x 16mm synergy stent was implanted to treat the left anterior descending artery (lad).The lcx was noted with severe in-stent restenosis at left circumflex (lcx) artery was treated with 2.5 mm x 8 mm synergy stent.On (b)(6) 2022, the subject presented emergently with complaints of worsening substernal pressure like chest pain, radiating to left neck and jaw.Sublingual nitroglycerin was given, that mildly decreased the chest pain from 8/10 to 2/10, along with imdur, which was ongoing at the time of admission.On examination, the subject was having shortness of breath, nausea, diaphoresis and mild epigastric discomfort.The subject was hospitalized on the same day for further evaluation and treatment.The subject was diagnosed with chest pain with acute coronary syndrome and acute inferior st elevation myocardial infarction.The subject was on clopidogrel at the time of the event.Coronary angiography revealed 50% stenosis at the distal degment and 40% stenosis at the distal segment of the lad and 99% in-stent restenosis (isr) in the proximal to distal lcx.Intravenous heparin drip and nitro paste drip with morphine was given as part of the procedure.The subject was on clopidogrel at the time of the event.The 99% isr was treated with percutaneous coronary intervention.The event was considered recovered/resolved and the subject was discharged on clopidogrel.On (b)(6) 2022, the subject presented emergently with worsening chest pain, which was not relieved by nitroglycerin.It was reported that the subject had experienced palpitation episodes at home with heart rate ranging from 40-186.The subject was hospitalized on the same day for further evaluation and treatment.The subject was diagnosed with severe isr involving the mid to distal large lcx.The subject was diagnosed with myocardial infarction and revascularization was recommended.On examination, the subject was having chest pain, occasional diaphoresis and shortness of breath.Medication was changed from eliquis to lovenox for paroxysmal atrial fibrillation.On (b)(6) 2022, diagnostic coronary angiography revealed 15% stenosis of the previously placed lad stent at the ostial to distal segment and 15% stenosis of the previously placed unknown stent at the 1st diagonal.Restenosis in the distal lcx was treated with percutaneous coronary intervention with a non-boston scientific stent.The event was considered resolved with sequelae and the subject was discharged on eliquis and brilinta.
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