Acute myocardial infarction complicated by sudden out-of-hospital cardiac arrest: a clinical case

Justification. One of the serious complications of acute myocardial infarction (AMI) is out-of-hospital cardiac arrest, which is associated with electrical instability of the myocardium, ventricular arrhythmias. The development of a complication in the presence of an emergency medical team requires immediate resuscitation measures, including basic resuscitation measures and defibrillation.Aim: To present a clinical case of a patient with AMI with ST segment elevation complicated by recurrent ventricular fibrillation, hospitalized in an emergency hospital with the possibility of performing invasive interventions.Methodology and methods of research. The analysis of anamnesis, electrocardiographic data of the patient, the results of coronary angiography and stenting of the coronary artery, echocardiography examination, Holter monitoring, laboratory studies was carried out.Results. Patient P., female, 81 years old, was taken to the emergency hospital 2 hours and 15 minutes after the start of the clinic. At the prehospital stage, recurrent ventricular fibrillation, stopped by repeated three defibrillations. Non-contact, twice bouts of motor arousal. The council decided to conduct coronary angiography with possible stenting of the coronary arteries immediately. It was performed by femoral access on the right in 30 minutes after hospitalization. Complete occlusion of the anterior interventricular artery was revealed. Conductor recanalization and stenting of permanent residence was performed using a drug-coated stent. In the intensive care unit, drip administration of dopamine, noninvasive ventilation of the lungs, heparin administration were continued; double antiplatelet therapy, atorvastatin, amiodarone were prescribed. Since the fourth day, a beta-blocker has been added to therapy. Physical and psychological rehabilitation was carried out. She was discharged on the 15th day in a satisfactory condition.Conclusion. Out-of-hospital cardiac death requires urgent resuscitation measures, among which defibrillation occupies a special place, as well as immediate hospitalization to a cardiology center with the possibility of performing invasive interventions. Early rehabilitation plays an important role in the treatment of patients.