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Micheal Lee Case Study
Micheal Lee, a 21 year-old man with a 40-pack-year smoking history and recent complaints of
angina upon exercising, collapsed while running a marathon. Paramedics arriving at the scene
found him unconscious, not breathing, and without a pulse. CPR was successfully performed and
Micheal was transported to the hospital. An ECG was suggestive of an anterior wall myocardial
infarction, and he was given an intravenous solution of tissue plasminogen activator (TPA).
Elevated blood creatine phosphokinase (CPK) levels measured over the next 3 days confirmed
the diagnosis. Coronary angiography was performed a week later, revealing the following
results:
Circumflex artery: 25% blocked
Right coronary artery: 30% blocked
Left anterior descending artery (LAD): 95% blocked
(“Anterior intraventricular artery”)
1. What is a myocardial infarction?
2. What is the cause of Micheal Lee’s myocardial infarction?
3. Why was Micheal experiencing Angina? (BE SPECIFIC)
4. Why are the levels of CPK an indicator of MI? (Hint:What is creatine?)
5. Why was he given TPA ?
6. What protein does TPA activate?
7. While listening to his heart with a stethoscope, you notice a high-pitched, blowing,
systolic murmur, heard best directly under the left nipple. A review of Micheal’s medical
records shows no prior history of a heart murmur. What is causing this new murmur?
8. Draw and label an EKG
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9. What abnormality might appear on Micheal’s EKG?
10. How is Michael’s Cardiac Output affected due to the heart attack?
11. Use the figure to label the following arteries that are blocked in Micheal Lee’s heart.
