Frequency of Complete Heart Block in Patients Presenting with Acute St-Segment Elevation Myocardial Infarction (STEMI)
DOI:
https://doi.org/10.70749/ijbr.v3i6.2495Keywords:
Heart block, Myocardial infarction, Myocardium, Risk factors, ST elevation.Abstract
Background: Acute ST-segment elevation myocardial infarction is one of the most serious type of heart attack where blood flow to part of heart muscle stop suddenly due to blockage of coronary artery, mostly by a clot forming on a ruptured plaque. It causes severe chest pain, sweating, and breath difficulty and need quick treatment to save life. Complete heart block is a serious complication in such patients, happen when the electrical signal from upper to lower chamber stop passing. This lead to very slow heart rate and can cause fainting or death if not managed quickly. Objective: To determine the frequency of complete heart block in patients presenting with Acute ST-Segment Elevation Myocardial Infarction STEMI to a tertiary care hospital. Study Design: Cross-sectional descriptive study. Duration and Place of Study: Conducted from September 2024 to March 2025 in the Department of Cardiology, Saidu Group of Teaching Hospital, Swat. Methodology: A total of 237 patients aged 18–70 years diagnosed with ST-segment elevation myocardial infarction were included by consecutive sampling. Diagnosis was based on chest pain, ECG changes, and raised cardiac biomarkers. Complete heart block was diagnosed when P waves and QRS complexes were independent on ECG. Results: Out of 237 patients, 169 (71.3%) were males. The mean age was 48.68±12.69 years. Complete heart block was found in 36 patients (15.20%). No significant association was found with age, gender, BMI, pain duration, residence, or comorbidities (p>0.05). Conclusion: This study has concluded that complete heart block is not rare in patients presenting with acute ST-segment elevation myocardial infarction and show serious clinical concern, mostly due to ischemic damage and treatment delay.
Downloads
References
1. Elendu C, Amaechi DC, Elendu TC, Omeludike EK, Alakwe-Ojimba CE, Obidigbo B, et al. Comprehensive review of ST-segment elevation myocardial infarction: Understanding pathophysiology, diagnostic strategies, and current treatment approaches. Medicine (Baltimore). 2023;102(43):e35687.
https://doi.org/10.1097/MD.0000000000035687
2. Khurana KV, Ranjan A. ST-segment elevation in conditions of non-cardiovascular origin mimicking an acute myocardial infarction: A narrative review. Cureus. 2022;14(10):e30868.
https://doi.org/10.7759/cureus.30868
3. Ansari S, Farzaneh N, Duda M, Horan K, Andersson HB, Goldberger ZD, et al. A review of automated methods for detection of myocardial ischemia and infarction using electrocardiogram and electronic health records. IEEE Rev Biomed Eng. 2017; 10:264-298.
https://doi.org/10.1109/RBME.2017.2757953
4. Mughal LH, Sastry S. Advances in the treatment of ST elevation myocardial infarction in the UK. JRSM Cardiovasc Dis. 2022; 11:20480040221075519.
https://doi.org/10.1177/20480040221075519
5. Curcio A, Scalise R, Indolfi C. Pathophysiology of atrial fibrillation and approach to therapy in subjects less than 60 years old. Int J Mol Sci. 2024;25(2):758.
https://doi.org/10.3390/ijms25020758
6. Huerta N, Malik S, Haas C. The heart block hat-trick: A case of alternating first-, second-, and third-degree heart blocks. Case Rep Cardiol. 2023; 2023:8664315.
https://doi.org/10.1155/2023/8664315
7. Choudhuri B, Agarwal N. Unusual cardiovascular response to sildenafil: Complete heart block in a healthy young adult. Cureus. 2025;17(2):e78560.
https://doi.org/10.7759/cureus.78560
8. Stark C, Bhat P, Rytkin E, Efimov IR. Temporary pacing for electric cardiac stimulation and neuromodulatory cardiovascular therapy. Cardiovasc Eng Technol. 2025;16(3):363-375.
https://doi.org/10.1007/s13239-025-00780-3
9. Potter T, Spencer K, White MD, Comp GB. A 56-year-old female with acute ST-segment elevation myocardial infarction, complete heart block, and hemodynamic instability. Cureus. 2021;13(1):e12857.
https://doi.org/10.7759/cureus.12857
10. Gholipour M, Noruzi S, Moayerifar M, Khalili A, Eftekhari B, Mirbolouk F, et al. The effect of extent and localization of precordial ST-segment depression in acute inferior myocardial infarction as an indicator of infarct severity, coronary artery involvement, and cardiac outcomes. Ther Adv Cardiovasc Dis. 2025; 19:17539447251326154.
https://doi.org/10.1177/17539447251326154
11. Kawamura Y, Yokoyama H, Kitayama K, Miura N, Hamadate M, Nagawa D, et al. Clinical impact of complete atrioventricular block in patients with ST-segment elevation myocardial infarction. Clin Cardiol. 2021;44(1):91-99.
https://doi.org/10.1002/clc.23510
12. Frampton J, Ortengren AR, Zeitler EP. Arrhythmias after acute myocardial infarction. Yale J Biol Med. 2023;96(1):83-94.
https://doi.org/10.59249/LSWK8578
13. Ullah Z, Khan I, Khan W, Khan MA. Frequency of complete heart block in patients with acute inferior wall myocardial infarction. J Med Sci. 2022;16(3):89-90.
https://doi.org/10.53350/pjmhs2216589
14. Dar UF, Adnan F, Azizullah M, Nasir M, Nayyer U. Atrioventricular blocks in patients of acute ST elevation myocardial infarction. Pak J Med Health Sci. 2015;9(3):823-825.
15. Bhalli MA, Khan MQ, Samore NA, Mehreen S. Frequency and clinical outcome in conduction defects in acute myocardial infarction. J Ayub Med Coll Abbottabad. 2009;21(3):32-36.
16. Hayat AS, Bawany MA, Qadri JA, Khalil K. Frequency of complete heart block in patients at a tertiary care hospital. Prof Med J. 2013;20(3):332-340.
17. Ali MZ, Younus I, Yousuf S, Javed M, Iqbal K, Altaf F. Complete heart blocks and in-hospital mortality after ST-segment elevation myocardial infarction. Prof Med J. 2021;28(7):1049-1052.
https://doi.org/10.29309/TPMJ/2021.28.07.6115
18. Khan MA, Sammar K, Naz R, Tauqeer S, Shafiq M, Naz S. Complete heart block in patients presenting with acute anterior wall myocardial infarction. J Ayub Med Coll Abbottabad. 2024;36(2):310-315.
https://doi.org/10.55519/JAMC-02-13024
19. Hussain S, Khan S, Waqas ul B, Tariq A, Javed H. Frequency of in-hospital mortality in patients presenting with STEMI and concurrent right bundle branch block. J Popul Ther Clin Pharmacol. 2024;31(8):132-139.
https://doi.org/10.53555/jptcp.v31i8.7311
20. Saleem N, Ahmad S, Sadiq Z, Ahmad G, Ahmed J, Munir S. Frequency of atrioventricular block in patients presenting with acute coronary syndrome and outcome comparison. J Cardiovasc Dis. 2022;18(1):22-29.
https://doi.org/10.55958/jcvd.v18i1.21
21. Pirzada AM, Zaman KS, Mahmood K, Sagheer T, Mahar SA, Jafri MH. High degree AV block in inferior MI with and without right ventricular involvement. J Coll Phys Surg Pak. 2009;19(5):269-274.
22. Mehmood S, Nazir F, Mumtaz SU, Khan AA, Iqtadar S, Abaidullah S. Frequency of reversibility of complete heart block in acute myocardial infarction. Esculapio J SIMS. 2023;19(1):34-37. https://doi.org/10.51273/esc23.251917
23. Hashim M, Zeb S, Shah GA, Rizvi SNH. In-hospital mortality in patients of ST elevation MI presenting with right bundle branch block. Pak Heart J. 2017;50(4):241-247.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
