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      Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

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          Abstract

          Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.

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          Most cited references16

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          2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.

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            Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

            The goal of therapy for bradycardia or tachycardia is to rapidly identify and treat patients who are hemodynamically unstable or symptomatic due to the arrhythmia. Drugs or, when appropriate, pacing may be used to control unstable or symptomatic bradycardia. Cardioversion or drugs or both may be used to control unstable or symptomatic tachycardia. ACLS providers should closely monitor stable patients pending expert consultation and should be prepared to aggressively treat those with evidence of decompensation.
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              2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay

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                Author and article information

                Journal
                SAGE Open Med Case Rep
                SAGE Open Med Case Rep
                SCO
                spsco
                SAGE Open Medical Case Reports
                SAGE Publications (Sage UK: London, England )
                2050-313X
                15 March 2021
                2021
                : 9
                : 2050313X21996113
                Affiliations
                [1 ]Kota Madiun General Hospital, Madiun, Indonesia
                [2 ]Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
                Author notes
                [*]Yudhistira Pradnyan Kloping, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen. Prof. Dr. Moestopo 47, Surabaya 60132, Indonesia. Email: distrayyss@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-7227-8349
                Article
                10.1177_2050313X21996113
                10.1177/2050313X21996113
                7970234
                1712647d-1165-4555-bb0d-c17edc9a17b1
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 26 September 2020
                : 25 January 2021
                Categories
                Case Report
                Custom metadata
                January-December 2021
                ts1

                complete atrioventricular block,nonreperfused acute inferior wall myocardial infarction,dopamine,epinephrine,rural hospital,case report

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