Case Report: Successful primary percutaneous coronary intervention in octogenarian with acute-on-chronic kidney disease and total atrioventricular block after acute myocardial infarction

病例报告:一名八旬老人在急性心肌梗死后出现急性加重型慢性肾病和完全性房室传导阻滞,经皮冠状动脉介入治疗成功。

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Abstract

Myocardial infarction (MI) is frequently complicated by the worsening of renal function. Undergoing primary percutaneous coronary intervention (PCI) becomes crucial to a patient with ST-segment elevation myocardial infarction (STEMI). With appropriate management of MI, acute-on-chronic kidney disease (ACKD) requiring dialysis post-MI remains an important clinical predictor of elevated in-hospital mortality among patients with MI.  In this study, we reported an octogenarian patient suffering from STEMI with ACKD and total atrioventricular block (TAVB). She underwent insertion of a temporary pacemaker and primary PCI. Renal function was improved after dialysis by decreasing the amount of serum creatinine from 8.1 mg/dL at admission to 1.05 mg/dL after primary PCI and dialysis. Primary PCI should still be considered for patients with acute MI, even though these patients have kidney disease, to save the heart muscle and even indirectly improve the kidney function itself.

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