New insights into the management of rhythm and conduction disorders after acute myocardial infarction.
METHODS
Male, 53 FINAL DIAGNOSIS: Myocardial infarction Symptoms: Chest pain • tachycardia


METHODS
- Clinical Procedure: - Specialty: Cardiology.


OBJECTIVE
Challenging differential diagnosis.


BACKGROUND
Comorbidities, including obesity and sleep-breathing disorders, can adversely influence outcomes in acute myocardial infarction (AMI), and should be considered in diagnosis and treatment administration.


METHODS
The case demonstrates the difficulties of treating a middle-aged Caucasian patient with multiple comorbidities that could be overcome by a personalized approach and evaluation of concomitant sleep-breathing disorders (by polysomnography study). Diagnosis and treatment of sleep apnea by positive airway pressure (PAP therapy) played a pivotal role in heart rate and rhythm control.


CONCLUSIONS
In this case, effective PAP therapy enabled titration of antiarrhythmic drugs (to maximal doses) to achieve heart rate control and to eliminate severe ventricular tachyarrhythmias and contributed to the better recovery in a post-AMI patient with left ventricular systolic dysfunction.
Department of Hypertension, Federal Almazov Medical Research Centre, St, Petersburg, Russian Federation.
Lyudmila
L
Korostovtseva
Department of Hypertension, Federal Almazov Medical Research Centre, St, Petersburg, Russian Federation.
Yurii
Y
Sviryaev
Department of Hypertension, Federal Almazov Medical Research Centre, St, Petersburg, Russian Federation.
Nadezhda
N
Zvartau
1 Department of Cardiology, Federal Almazov Medical Research Centre, St. Petersburg, Russian Federation.
Tatiana
T
Druzhkova
Department of Functional Diagnostics, Federal Almazov Medical Research Centre, St. Petersburg, Russian Federation.
Viktor
V
Tikhonenko
Department of Functional Diagnostics, Federal Almazov Medical Research Centre, St. Petersburg, Russian Federation.
Alexandra
A
Konradi
Acute Coronary Syndrome; Comorbidity; Sleep Apnea Syndromes; Tachycardia