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Case Reports
. 2014 Jul;29(4):299-301.
doi: 10.5001/omj.2014.78.

Cardiogenic Shock with Complete Atrio-ventricular Block in an Octogenarian Woman: Are we going too far?

Ziad Dahdouh  1 , Adrien Lemaitre  1 , Vincent Roule  1 , Vincent Troussard  1 , Gilles Grollier  1
Affiliations
Case Reports

Cardiogenic Shock with Complete Atrio-ventricular Block in an Octogenarian Woman: Are we going too far?

Ziad Dahdouh et al. Oman Med J. 2014 Jul.

Abstract

We report a case of an octogenarian woman who suffered from cardiogenic shock following an inferolateral myocardial infarction extending to the right ventricle associated with complete atrioventricular heart block. Her initial status was critical with a poor prognosis. She requested an invasive full management to be able to continue to take care of her ill husband. She was managed with circulatory assistance, temporary pacing and percutaneous coronary intervention. The procedure was successfully performed and the patient showed a remarkable improvement in clinical condition. Cardiogenic shock complicating right heart ventricle in elderly requires careful patient selection for invasive strategies that can sometimes rely on the willingness of the patient, as the procedural outcome appears to be poor in this high-risk population.

Keywords: Cardiogenic shock; Octogenarian; Percutaneous coronary intervention.

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Figures

Figure 1
Figure 1
Temporary pacing (white arrows) and intra-aortic balloon pump (black arrows) were inserted before the percutaneous coronary intervention.
Figure 2
Figure 2
Proximal thrombotic occlusion of the right coronary artery.
Figure 3
Figure 3
Right coronary artery after the percutaneous coronary intervention using a Bare Metal Stent (Integrity 3.0 mm × 30 mm, Biotronik, Erlangen, Germany).
See this image and copyright information in PMC

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