Why the study?
Total AV block is the most common conduction disorder in ACS requiring timely recognition and treatment, but optimal conservative management in limited-resource rural settings without immediate PCI access requires demonstration.
In resource-limited settings where immediate revascularization and pacemaker implantation are not feasible, conservative management with antithrombotics and epinephrine may successfully treat total AV block complicating NSTEMI.
Answers are grounded in this paper and cite their sources.
May support temporary conservative management of AV block in NSTEMI without PCI; hypothesis-generating and requires prospective validation.
Total atrioventricular (AV) block is the most common type of conduction disorder found in acute coronary syndrome (ACS), which requires timely recognition and treatment. This case report aimed to present conservative medical treatment for managing total AV block (TAVB) in a very high-risk non-ST-elevation myocardial infarction (NSTEMI) in a rural area. We reported a patient with TAVB in a very high-risk NSTEMI. The patient was hemodynamically unstable and needed immediate percutaneous coronary intervention (PCI). Due to limited facilities and difficult access to immediate PCI, the patient was treated conservatively with the NSTEMI protocol. Epinephrine, as a β-adrenergic agonist, was administered to improve hemodynamic status. During conservative treatment, TAVB was converted into the first-degree AV block on the third day of intensive care. In a setting where revascularization strategies and pacemaker implantation are not feasible, administration of antithrombotic agents and β-adrenergic agonists can be considered to manage TAVB with NSTEMI with close monitoring.
No takes yet. Share an insight, caveat, or question.
Anggraeni et al. (2024) studied this question.
Synapse has enriched 8 closely related papers on similar clinical questions. Consider them for comparative context: