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Article: Evacuation of Non-ST Elevation Myocardial Infarction in West Africa: 19 Hours of Lessons Learned in Prolonged Casualty Care and En Route Care.

Speicher, Matthew V / McGowan, Joel / Pruett, Sean / Shurden, Jaimie / Bianchi, William D / Kibler, Aaron

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals

2023  Volume 23, Issue 1, Page(s) 114–116

Abstract: Trauma casualty care has historically been the cornerstone of special operations military medical training. A recent case of myocardial infarction at a remote base of operations in Africa highlights the importance of foundational medical knowledge and ... ...

Abstract Trauma casualty care has historically been the cornerstone of special operations military medical training. A recent case of myocardial infarction at a remote base of operations in Africa highlights the importance of foundational medical knowledge and training. A 54-year-old government contractor supporting operations in the AFRICOM area of responsibility (AOR) presented to the Role 1 medic with substernal chest pain with onset during exercise. Abnormal rhythm strips concerning for ischemia were obtained from his monitors. A MEDEVAC to a Role 2 facility was arranged and executed. At the Role 2 a non-ST-elevation myocardial infarction (NSTEMI) was diagnosed. The patient was emergently evacuated on a lengthy flight to a civilian Role 4 treatment facility for definitive care. He was found to have a 99% occlusion of the left anterior descending (LAD) coronary artery, as well as a 75% occlusion of the posterior coronary artery and a chronic 100% occlusion of the circumflex artery. The LAD and posterior arteries were stented, and the patient made a favorable recovery. This case highlights the importance of preparedness for medical emergencies and care of medically critical patients in remote and austere locations.
MeSH term(s) Male ; Humans ; Middle Aged ; Non-ST Elevated Myocardial Infarction/surgery ; Electrocardiography ; Myocardial Infarction/diagnosis ; Myocardial Infarction/therapy ; Coronary Vessels ; Africa, Western ; Coronary Angiography
Language English
Publishing date 2023-03-06
Publishing country United States
Document type Journal Article
ZDB-ID 3006517-3
ISSN 1553-9768
ISSN 1553-9768
DOI 10.55460/JIDF-CWE7
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