Asystole is a rare primary manifestation in the development of sudden cardiac death (SCD), and survival during cardiac arrest as the consequence of asystole is extremely low. The aim of our paper is to illustrate successful cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) and rare and severe form of cardiac arrest - asystole. A very short time between cardiac arrest in acute myocardial infarction, which was manifested by asystole, and the adequate CPR measures that have been taken are of great importance for the survival of our patient.
After successful reanimation, the diagnosis of anterior wall AMI with ST segment elevation was established. The right therapeutic strategy is certainly the early primary percutaneous coronary intervention (PPCI). In less than two hours, after recording the “flatline” and successful reanimation, the patient was in the catheterization laboratory, where a successful PPCI of LAD was performed, after emergency coronary angiography. In the further treatment course of the patient, the majority of risk factors were corrected, except for smoking, which may be the reason for newly discovered lung tumor disease. Early recognition and properly applied treatment of CPR can produce higher rates of survival.
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1. Zipes DP Camm AJ Borggrefe M et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death – executive summary: Eur Heart J 2006;27:2099–140. https://doi.org/10.1016/j.jacc.2006.07.008
2. Loyd JD Adams RJ Brown TM et al. Heart disease and stroke statistics – 2010 update: a report from the American Heart Association. Circulation 2010; 121:e46-215. https://doi.org/10.1161/CIRCULATIONAHA.109.192667
3. Gillum RF. Gographic variation in sudden coronary death. Am Heart J 1990; 119:380-9. https://doi.org/10.1016/S0002-8703(05)80031-6
4. Simmons A Pimental R Lakkireddy D. Sudden cardiac death in women. Rev Cardiovasc Med 2012; 13:e37-42.
5. Zheng ZJ Croft JB Giles WH Mensah GA. Sudden Cardiac Death in the United States 1989 to 1998. Circulation 2001; 104:2158-63. https://doi.org/10.1161/hc4301.098254
6. Myberg RJ Castellanos A. Cardiac Arres and Sudden Cardiac Death. In: Zipes DP Libby P Bonow RO Braunwald E editors. Braunw-ald s Heart Disease. A Textbook of Cardiovascular Medicine. Philadelphia: Elsevir Saunders 2005; 865-908.
7. Myberg R Juntilla MJ. Sudden Cardiac Death caused by Coronary Heart disease. Circulation 2012; 125:1043-52. https://doi.org/10.1161/CIRCULATIONAHA.111.023846
8. Vimani R Burke AP Farb A. Sudden cardiac death. Cardiovascular pathology 2001; 10:211-8. https://doi.org/10.1016/S1054-8807(01)00091-6
10. Tedesco C Reigle J James B. Sudden cardiac death in heart failure. Journal of Cardiovascular Nursing 2000; 14:38-56. https://doi.org/10.1097/00005082-200007000-00004
11. Koenraad G. Monsieurs Jerry P Nolan Leo l. Bossaert et al: European Resuscitation Council Guidelines for Resuscitation 2015;95:81-99.
12. Trpković S Pavlović A Videnović N et al. Značaj uspostavljanja disajnog puta i rane defibrilacije na preživljavanje pacijenata koji su doživeli vanbolnički akutni zastoj srca. Praxis medica 2010; 38:33-8.
13. Keeley EC Boura JA Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003 Jan 4; 361(9351):13-20. https://doi.org/10.1016/S0140-6736(03)12113-7
14. Andersen HR Nielsen TT Rasmussen K. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction N Engl J Med. 2003 Aug 21; 349(8):733-42. https://doi.org/10.1056/NEJMoa025142
15. Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med. 1989; 321:406-12. https://doi.org/10.1056/NEJM198908103210629
16. Priori S Blomström-Lundqvist C Mazzanti A et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Eur Heart J 2015;36:2793–2867. https://doi.org/10.1093/eurheartj/ehv316
17. Julian DG Camm AJ Frangin G et al. Randomised trial of effect of amiodarone on mortality in patients with left ventricular disfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. Lancet 1997; 349:667-76. https://doi.org/10.1016/S0140-6736(96)09145-3
18. Cairns JA Connolly SJ Roberts R Gent M. Randomised trial on outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Inestigators. Lancet 1997; 349:675-86.https://doi.org/10.1016/S0140-6736(96)08171-8
19. Boutitie F Boissel JP Connolly JP et al. Amiodarone interaction with beta-blockers: analysis of the merged EMIAT (European Myocardial Infarct Amiodarone Trial) and CAMIAT(Canadian Amiodarone Myocardial Infarction Arrhythmia Trial) databases. Circulation 1999; 99:2268-76. https://doi.org/10.1161/01.CIR.99.17.2268
20. Moss AJ Zareba W Hall WJ et al. Prophylactic implantation of a defibrilator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002; 346:877-85. https://doi.org/10.1056/NEJMoa013474