An electrocardiogram at Tam Anh General Hospital Hanoi revealed Mrs. Thuy had ST elevation accompanied by complete atrioventricular block, a dangerous complication that can lead to a slow heart rate or even cardiac arrest. Doctors implanted a temporary pacemaker to maintain her heart rhythm and stabilize hemodynamics before performing a coronary angiography to determine the cause. The patient was found to have a 95% stenosis in her right coronary artery, reducing blood flow to the heart muscle.

According to Dr. Phung Van Thao, from the Cardiology Department, complete atrioventricular block is a severe complication of myocardial infarction. When the heart's electrical conduction system is damaged, the heart may beat very slowly or stop briefly, causing a drop in blood pressure, fainting, or circulatory arrest. In this case, a temporary pacemaker helps maintain the heart rate, providing sufficient time to address the cause of the coronary artery blockage.

The medical team performed balloon angioplasty and placed additional stents to restore blood flow. The patient had a history of stent placement and multiple underlying conditions, including heart failure, reduced left ventricular systolic function, hypertension, atrial fibrillation, ventricular premature beats, dyslipidemia, prediabetes, and lower limb venous insufficiency, all of which increased the risk of intervention complications.

After coronary artery revascularization, Mrs. Thuy's heart rate and hemodynamics gradually stabilized, and her chest pain and shortness of breath improved. The temporary pacemaker was removed the following day. She continued treatment with antiplatelet drugs, lipid-lowering drugs, and management for heart failure and other co-existing conditions.

Dr. Thao checks Mrs. Thuy's health before her discharge. Photo: Tam Anh General Hospital

Myocardial infarction can lead to severe complications such as slow heart rhythms, atrioventricular block, ventricular septal rupture, and death. Patients require immediate emergency care to revascularize the blood vessels within the "golden hour" to limit the area of necrotic heart muscle.

Dr. Thao noted that stent placement does not mean coronary artery disease is completely cured. Atherosclerosis is a chronic disease that can involve multiple lesions in different locations. After intervention, patients must adhere to medication, attend scheduled follow-up appointments, control blood pressure, blood sugar, and blood lipids, and maintain a healthy diet and appropriate exercise to reduce the risk of recurrent myocardial infarction.

Elderly individuals or those with hypertension, diabetes, dyslipidemia, a history of smoking, obesity, or a prior history of coronary artery disease should seek immediate medical attention if they experience chest pain lasting over 15-20 minutes, pain radiating to the shoulder, arm, neck, or jaw, accompanied by shortness of breath. Early emergency care and coronary revascularization reduce the risk of heart failure.

Thanh Ba