Treatment of Acute RVMI Complicated by High-Grade Bradycardia-Induced Shock Using Pacing-PTCA-ICT Combination

Year : 2024 | Volume :13 | Issue : 01 | Page : 19-23
By

Hui-Chol Kang

Abstract

Acute RVMI (right ventricular myocardial infarction), which would be possibly followed by bradycardia-induced shock, may perpetuate a vicious circle very quickly and result in short-term adverse outcomes as cardiac arrest and long-term outcomes as angina pectoris or recurrent myocardial infarction. In order to block this circle, emergent combination of temporary pacing and PTCA (percutaneous transluminal coronary angioplasty) may be necessary, and especially, in unexpected case that the occlused lesion is long, another addition of ICT (intracoronary thrombolysis) may improve outcomes. The presented case highlights the efficacy of a multifaceted approach in managing acute right ventricular myocardial infarction (RVMI) complicated by high-grade bradycardia-induced shock in a 65-year-old patient. This comprehensive strategy involved the synergistic use of temporary pacing, percutaneous transluminal coronary angioplasty (PTCA), and intra-aortic balloon counterpulsation therapy (ICT) to mitigate the risk of cardiac death. By swiftly addressing both the underlying myocardial infarction through PTCA and the hemodynamic instability through temporary pacing and ICT, the patient’s condition was stabilized, averting potentially fatal consequences. This integrated intervention paradigm underscores the importance of tailored, multidisciplinary approaches in critical cardiac scenarios, particularly in cases of acute inferior myocardial infarction with concomitant right coronary artery occlusion leading to profound bradycardia-induced shock. Such combined interventions not only serve as a resuscitative measure but also significantly contribute to favorable prognostic outcomes in these high-risk clinical contexts.

Keywords: Acute RVMI, bradycardia-induced shock, percutaneous transluminal coronary angioplasty (PTCA), intracoronary thrombolysis (ICT), cardiac arrest, angina pectoris, temporary pacing, cardiac death.

[This article belongs to Research & Reviews : Journal of Medical Science and Technology(rrjomst)]

How to cite this article: Hui-Chol Kang. Treatment of Acute RVMI Complicated by High-Grade Bradycardia-Induced Shock Using Pacing-PTCA-ICT Combination. Research & Reviews : Journal of Medical Science and Technology. 2024; 13(01):19-23.
How to cite this URL: Hui-Chol Kang. Treatment of Acute RVMI Complicated by High-Grade Bradycardia-Induced Shock Using Pacing-PTCA-ICT Combination. Research & Reviews : Journal of Medical Science and Technology. 2024; 13(01):19-23. Available from: https://journals.stmjournals.com/rrjomst/article=2024/view=137717


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Regular Issue Subscription Case Report
Volume 13
Issue 01
Received December 2, 2023
Accepted February 6, 2024
Published April 1, 2024
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