Persistent complete atrioventricular (AV) block in a patient with an atypical presentation of AMI: a case repor
When a tissue suffers ischemia, time is a crucial therapeutic and prognostic factor. Patients that do not express chest pain while they experience an acute myocardial infarction (AMI) are considered as an atypical presentation, and are more likely not to arrive in window period for reperfusion thera...
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| Auteurs principaux: | , , , |
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| Format: | Online |
| Langue: | spa |
| Publié: |
REMUS - Revista Estudiantil de Medicina de la Universidad de Sonora
2020
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| Accès en ligne: | https://ojs-remus.unison.mx/index.php/remus_unison/article/view/36 |
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| Résumé: | When a tissue suffers ischemia, time is a crucial therapeutic and prognostic factor. Patients that do not express chest pain while they experience an acute myocardial infarction (AMI) are considered as an atypical presentation, and are more likely not to arrive in window period for reperfusion therapy. This situation triggers a series of events that influence negatively in the prognosis compared to patients with typical presentation. Complete atrioventricular (AV) block is an electrical complication in ST elevation AMI, associated with a less favorable evolution, and even worse when reperfusion therapy is not implemented, since it is associated with a longer duration of the arrythmia, longer hospital stay and higher mortality at 30 and 365 days. We present the case of a 50 year old male who suffered an inferior AMI with anteroseptal extension, complicated with a complete atrioventricular (AV) block, who denied any kind of thoracic discomfort, and decided to go to the hospital 72 hours after the symptoms started. Therefore, it was decided not to reperfuse. This complication is usually transient, thus persistent presentations are rare and are associated with severe AV node necrosis. Our patient is one of the few cases with AMI in which a permanent pacemaker is indicated. The atypical presentation factor had an impact on the evolution and prognosis of the patient. Thereby, the main goal of this case report is to make first contact physicians aware of how important is to identify and manage an atypical AMI as soon as possible. |
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