Browsing by Author "Mahat, P"
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Publication Reversing AV Block and Cardiogenic Shock in STEMI Care: A Case Report on Use of Fibrinolysis and Inotrope without PCI in Rural Nepal(Kathmandu University, 2025) Pradhan, A; Tamrakar, P; Bhandari, J; Mahat, PABSTRACT Atrioventricular block and cardiogenic shock are critical complications of inferior wall myocardial infarction with high mortality, especially in resource-limited settings lacking percutaneous coronary intervention. We report a 53-year-old male smoker presenting to a rural hospital with acute chest pain, dyspnea, and profound hemodynamic instability with electrocardiogram showing inferior wall ST-segment elevation myocardial infarction with Mobitz type I atrioventricular block. This case highlights reversal of atrioventricular block with return of hemodynamic stablility using Streptokinase and ionotropes in a rural setting. Therefore, timely fibrinolysis and inotropes in managing inferior wall myocardial infarction with atrioventricular block and cardiogenic shock in percutaneous coronary intervention -inaccessible regions and strengthening rural ST segment elevation myocardial infarction care networks is crucial. KEY WORDS Atrioventricular block, Fibrinolysis, Percutaneous coronary intervention, Rural health, Shock cardiogenic, ST elevation myocardial infarction