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"Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the electrocardiogram to divide patients into ST-elevation acute myocardial infarction (STEMI) or non-ST-elevation acute myocardial infarction (NSTEMI)/unstable angina (UA). Patients with STEMI in the earliest time will receive reperfusion therapy to destruct occlusive thrombus. An ST segment elevation is the sine qua non for diagnosing acute total coronary occlusion causing transmural myocardial infarction. Left circumflex coronary artery (LCx) occlusion is often categorized as NSTEMI because of the absence of significant ST-elevation on the 12 lead standard electrocardiogram. An ST segment elevation is presented in fewer than 50% of patients with LCx total occlusion, such that the reperfusion therapy is delayed. We reported a 77 years old woman whom being diagnosed with NSTEMI because a 12 lead electrocardiogram showed ST segment depression in lead V2-V5. On coronary angiography, we found a total occlusion in the LCx artery as the culprit lession.

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Pedoman manajemen pada pasien dengan sindroma koroner akut tergantung pada pembagian diagnosis menjadi infark miokard dengan elevasi segmen ST (IMA-EST) atau infark miokard akut tanpa elevasi segmen ST (IMA-NEST)/angina pektoris tidak stabil (APTS). Pasien dengan IMA-EST seawal mungkin dilakukan terapi reperfusi koroner untuk melisiskan trombus yang oklusif. Elevasi segmen ST merupakan kondisi ‘sine qua non’ untuk mendiagnosis oklusi total akut pada segmen arteri koroner yang menyebabkan infark miokard transmural. Oklusi total pada arteri circumflexus kiri (LCx) sering dikategorikan sebagai IMA-NEST karena tidak adanya elevasi segmen ST yang bermakna pada sadapan standar elektrokardiogram. Elevasi segmen ST ditemukan kurang dari 50% pada pasien dengan oklusi total LCx, sehingga terapi reperfusi terlambat diberikan. Kami melaporkan seorang wanita berusia 77 tahun yang didiagnosis IMA-NEST dengan gambaran elektrokardiogram 12 sadapan berupa depresi segmen ST di sadapan V2-V5. Pada angiografi koroner ditemukan lesi culprit berupa oklusi total pada LCx."

"Covers the complete syllabus of the subject prescribed by the Dental Council of India. Practical aspects of dentistry are covered in depth, including tooth carving, tooth identification and assessment of approximate age of a specimen dental cast. The book also covers comparative dental anatomy, dental anthropology and forensic odontology."