Clinical case of acute coronary syndrome with ST segment elevation complicated by complete heart block, acute heart failure, and sudden cardiac arrest

V.Ye. Kryzhanovskyi, V.B. Krasiuk, H.O. Danylova, D.O. Dziuba


Background. The study of new methods of treatment and prevention of cardiovascular diseases is one of the most urgent tasks of modern medicine. Every year in Ukraine, acute myocardial infarction occurs in 40,000 people. Mortality due to acute myocardial infarction reaches 3 %. Objective: to investigate a clinical case of a patient with acute coronary syndrome complicated by third-degree atrioventricular block. Materials and methods. The material of the study was a clinical case of a 78-year-old woman who had been rushed by an emergency medical team. The patient sought help with complaints of chest and abdominal pain, which appeared suddenly against the background of relative well-being. The exa­mination revealed clinical and electrocardiographic signs of acute coronary syndrome with ST segment elevation. The patient’s condition began to deteriorate rapidly, which was due to complications: complete heart block and acute heart failure. Treatment under the standard of care was not successful. Subsequently, there was a sudden cardiac arrest, and resuscitation measures were started. The ECG monitor recorded defibrillatory rhythms for 12 minutes. The reverse causes of cardiac arrest were actively treated. Resuscitation did not lead to success and was discontinued 34 minutes after the start of cardiopulmonary resuscitation. Results and conclusions. Emergency care team carried out all necessary measures to assist the patient with acute coronary syndrome, performed resuscitation and active treatment of reversed causes of death. During resuscitation, all possible rhythms are recorded: ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity, asystole, torsades de pointes ventricular tachycardia given in the paper. The correctness of the actions, their full compliance with the current recommendations on providing care is a priority of organization of the emergency medical service. The implementation of the recommendations makes it possible to identify all the prevailing “points” and to eliminate them.


acute coronary syndrome; complete heart block; cardiopulmonary resuscitation


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