A Cautionary Tale of Triple Therapy

Negeen Shahandeh; Jeffrey Harrell; Eric H Yang; Rushi V Parikh

doi:10.1016/j.jaccas.2021.03.013

A Cautionary Tale of Triple Therapy

JACC Case Rep. 2021 May 5;3(5):789-794. doi: 10.1016/j.jaccas.2021.03.013. eCollection 2021 May.

Authors

Negeen Shahandeh¹, Jeffrey Harrell¹, Eric H Yang¹, Rushi V Parikh¹

Affiliation

¹ Division of Cardiology, University of California-Los Angeles, Los Angeles, California, USA.

Abstract

A 54-year-old man with a history of atrial flutter presented with anterior ST-segment elevation myocardial infarction complicated by cardiogenic shock and underwent percutaneous coronary intervention of the left main coronary artery. He was placed on triple antithrombotic therapy and ultimately recovered. However, before discharge, he developed hypotension, confusion, and hemiplegia. (Level of Difficulty: Beginner.).

Keywords: DOAC, direct oral anticoagulant; ICA, internal carotid artery; LMCA, left main coronary artery; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction; acute coronary syndrome; anticoagulation; echocardiography; hemorrhage; pericardial effusion; tamponade.

Publication types

Case Reports