Author(s)

Khadimu Rassoul Diop¹, Mame Awa Sene², Serigne Mor Beye³, Joseph Salvador Mingou¹, Aliou Alassane Ngaïdé², Youssou Diouf¹, Papa Guirane Ndiaye⁴, Cheikh Mouhamadou Bamba Diop⁴, Marguerite Tening Diouf², Adama Kane³, Maboury Diao¹, Abdoul Kane²

¹Department of Cardiology, CHU Aristide Le Dantec, Dakar, Senegal.
²Department of Cardiology, Dalal Jamm Hospital, Dakar, Senegal.
³Department of Cardiology, Saint Louis Regional Hospital, Saint Louis, Senegal.
⁴Department of Cardiology, Idrissa Pouye General Hospital, Dakar, Senegal.

Introduction: ST-Segment Elevation Myocardial Infarction (STEMI) usually involves complete thrombotic occlusion of a coronary artery and require urgent reperfusion; it is one of the leading cause of global mortality and morbidity worldwide. A variety of mechanical, rhythmic, conductive, embolic or hemodynamic complications can occur following STEMI, especially when the treatment is delayed or inadequate. Clinical presentation: A 58-year-old patient with hypertension was admitted to our department for a circumferential STEMI complicated by an ischemic stroke; received 24 hours after the onset of pain. His blood pressure was 100/60 mmHg, heart rate was 55 beats/min. The examination revealed right central facial paralysis and a slight motor deficit of the right upper limb (muscle strength 4/5). The first electrocardiogram (ECG) showed a significant circumferential ST-segment elevation with Q waves in the same territory, as well as a Luchiani Wenckebach atrio-ven- tricular block. The first echocardiography performed showed apical akinesia along with the presence of an apical thrombus. Coronarography was not performed because it was not available and the patient was given curative low molecular weight heparin combined with dual antiplatelet therapy, an angiotensin converting enzyme inhibitor and high dose statins. Seventy-two hours later, the ECG showed a complete atrioventricular block with narrow QRS and the average ventricular rate was 51 beats/min. The patient was asymptomatic. Another echocardiography was performed to assess new complications and showed a rupture of the left ventricular wall and a moderate amount of circumferential pericardial effusion, without any sign of cavity compression. No particular therapeutic attitude was adopted apart from close monitoring with daily ECG and echocardiography. Ten days later, spontaneous regression of the AV Bloc was noted. Conclusion: ST-Segment Elevation Myocardial Infarction is a major cause of morbidity and mortality worldwide. A variety of complications can occur after myocardial infarction, especially when revascularisation is delayed or inadequate.

Myocardial Infarction, Delayed Reperfusion, Complication

Diop, K. , Sene, M. , Beye, S. , Mingou, J. , Ngaïdé, A. , Diouf, Y. , Ndiaye, P. , Diop, C. , Diouf, M. , Kane, A. , Diao, M. and Kane, A. (2023) St-Segment Elevation Myocardial Infarction with Multiple Complications: A Case Report. World Journal of Cardiovascular Diseases, 13, 124-129. doi: 10.4236/wjcd.2023.133010.