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Unveiling The Diagnosis Pitfall: Complete Heart Block Presenting In Acute Coronary Syndromes Without Chest Pain And Non-Ischemic Electrocardiography In A Young Adult

Heart Science Journal · Vol. 4 No. 4 (2023) · pp. 36–31

DOI
10.21776/ub.hsj.2023.004.04.8
ISSN
2721-9984, 2721-9976
Published
2023-10-01
Publisher
Universitas Brawijaya
Language
en

Abstract

Background: The majority of studies indicate that the asymptomatic or atypical presentation of acute coronary syndrome (ACS) as a significant manifestation of coronary artery disease (CAD) is associated with a poor prognosis.Objective: The purpose of this study was to characterize the clinical characteristics and management of ACS patients who presented without chest pain and non-ischemic electrocardiogram (ECG).Case presentation: A 31 years old man with syncope was brought to our hospital. ECG revealed total AV block (TAVB) without ST segment changes. First, he was diagnosed with cardiac syncope because his ECG showed no ischemic sign. He had a strong familial history of CAD, so we examined his cardiac enzymes and found an increase in serial cardiac enzymes. Then, he was diagnosed with non-ST elevation myocardial infarction (NSTEMI). Early invasive strategy with chronic total occlusion (CTO) at osteal right coronary artery (RCA) and acute total occlusion at mid RCA with implantation of 1 DES at osteal-proximal RCA was selected for this patient. After five days of hospitalization, he discharged home with medicines. Conclusion: In order to significantly lower their morbidity and mortality, this group of high-risk patients needs to receive improved early diagnostic and treatment choices.

Keywords

Collaboration network of the authors

40 authors · 270 co-authorship links · showing the 40 most connected

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  • University of Brawijaya
  • Affiliation unknown
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  • Same organisation
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Mohammad Saifur RohmanAffiliation unknown48
Novi KurnianingsihAffiliation unknown32
Setyasih AnjarwaniAffiliation unknown23
Cholid Tri TjahjonoAffiliation unknown23
Indra PrasetyaAffiliation unknown23
Djanggan SargowoAffiliation unknown21
Heny MartiniAffiliation unknown20
Budi SatrijoAffiliation unknown19
Wella KarolinaAffiliation unknown11
Nikhen NoverikeAffiliation unknown7
Yoga WaranugrahaAffiliation unknown7
Adhika Prastya WikanandaAffiliation unknown6
Valerinna YogibuanaAffiliation unknown6
Valerinna Yogibuana Swastika PutriAffiliation unknown5
Imelda KrisnasariAffiliation unknown4
Lukitasari Ayu GaluhAffiliation unknown4
Putri Annisa KamilaUniversity of Brawijaya4
Icmi Dian RochmawatiAffiliation unknown3
Olivia HandayaniAffiliation unknown3
Veny KurniawatiAffiliation unknown3
Tonny AdriyantoAffiliation unknown3
Fahmy RusnantaAffiliation unknown3
Fitranti Suciati LaitupaAffiliation unknown3
Muhammad Rizki FadlanAffiliation unknown3
Dea Arie KurniawanAffiliation unknown3
Seprian WidasmaraAffiliation unknown3
Harris KristantoAffiliation unknown3
Puspa LestariAffiliation unknown2
Anita Surya SantosoAffiliation unknown2
Ayu Asri Devi AdityawatiAffiliation unknown2
Muhammad Saifur RohmanAffiliation unknown2
Taufieq Ridlo MakhmudAffiliation unknown2
Faris Wahyu NugrohoAffiliation unknown2
Dedy IrawanAffiliation unknown2
Dyah Ayu IkeningrumAffiliation unknown2
Ardhani GalihAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Unveiling The Diagnosis Pitfall: Complete Heart Block Presenting In Acute Coronary Syndromes Without Chest Pain And Non-Ischemic Electrocardiography In A Young Adult</dc:title>
	<dc:creator xml:lang="en">Suprayoga, Imam Mi'raj</dc:creator>
	<dc:creator xml:lang="en">Rizal, Ardian</dc:creator>
	<dc:creator xml:lang="en">Widito, Sasmojo</dc:creator>
	<dc:creator xml:lang="en">Rahimah, Anna Fuji</dc:creator>
	<dc:subject xml:lang="en">Acute Coronary Syndrome</dc:subject>
	<dc:subject xml:lang="en">Heart Block</dc:subject>
	<dc:subject xml:lang="en">Chest Pain</dc:subject>
	<dc:description xml:lang="en">Background: The majority of studies indicate that the asymptomatic or atypical presentation of acute coronary syndrome (ACS) as a significant manifestation of coronary artery disease (CAD) is associated with a poor prognosis.Objective: The purpose of this study was to characterize the clinical characteristics and management of ACS patients who presented without chest pain and non-ischemic electrocardiogram (ECG).Case presentation: A 31 years old man with syncope was brought to our hospital. ECG revealed total AV block (TAVB) without ST segment changes. First, he was diagnosed with cardiac syncope because his ECG showed no ischemic sign. He had a strong familial history of CAD, so we examined his cardiac enzymes and found an increase in serial cardiac enzymes. Then, he was diagnosed with non-ST elevation myocardial infarction (NSTEMI). Early invasive strategy with chronic total occlusion (CTO) at osteal right coronary artery (RCA) and acute total occlusion at mid RCA with implantation of 1 DES at osteal-proximal RCA was selected for this patient. After five days of hospitalization, he discharged home with medicines. Conclusion: In order to significantly lower their morbidity and mortality, this group of high-risk patients needs to receive improved early diagnostic and treatment choices.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2023-10-01</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/13666</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2023.004.04.8</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac Care Unit ICCU; 36-31</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2023.004.04</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/13666/379</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2023 Imam Mi'raj Suprayoga, Ardian Rizal, Sasmojo Widito, Anna Fuji Rahimah</dc:rights>
</oai_dc:dc>