Key result
Patient suffers fatal sudden cardiac arrest four hours after transfer from ICCU to general ward.
Why the study?
Patients with acute myocardial infarction remain at risk of sudden deterioration after transfer from the intensive care unit to the general ward, necessitating strict monitoring and careful transfer-readiness assessment.
Case Report (n=1)
No
This case highlights that apparent clinical stability is insufficient for transferring post-PCI STEMI patients, emphasizing the need for rigorous transfer readiness assessments and strict post-transfer monitoring to prevent fatal outcomes.
Highlights risks of early post-ICCU transfer in apparently stable patients; leaves open need for refined discharge criteria in future studies.
Introduction: Patients with acute myocardial infarction remain at risk of sudden deterioration after transfer from the intensive care unit to the general ward, highlightingthe importance of strict monitoring, careful transfer-readiness assessment, and vigilantnursing observation to prevent fatal outcomes. Objective: This case study aims to describe the nursing care of a patient with STEMI duringICCU and the transition from the ICCU to the general ward.Case: A 58-year-old woman was admitted to the ICCU after PCI with ST-elevationmyocardial infarction (STEMI) and cardiogenic shock. She had a medical history ofhypertension, diabetes mellitus, and dyslipidemia, with no history of chest pain or smoking.Supporting examinations revealed elevated leukocyte count, troponin I, random bloodglucose, and prothrombin time. The patient also experienced metabolic acidosis andcardiomegaly, while electrocardiography demonstrated inferior ST-segment elevation. Thepatient received oxygen therapy, intravenous fluids, vasoactive support, diuretics,anticoagulants, antiplatelets, statins, and insulin. Conclusions: After four days of treatment in the ICCU, the patient was transferred to the general ward in a stable condition. However, she subsequently developed recurrent chestpain while eating, followed by cardiac arrest, and died despite 30 minutes ofcardiopulmonary resuscitation. This case emphasizes the need for standardized clinicalassessment before transferring patients with acute myocardial infarction from the ICCU tothe general ward. It also highlights the importance of close monitoring during the first 24hours after transfer to ensure early detection of clinical deterioration and to reduce the riskof fatal outcomes.
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Hidayati et al. (2026) conducted a case report in ST-Elevation Myocardial Infarction (STEMI) (n=1). ICU-to-ward transfer was evaluated on Sudden cardiac arrest and death. The patient experienced recurrent chest pain followed by sudden cardiac arrest and died 4 hours after being transferred from the ICCU to the general ward in an apparently stable condition.
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