ELECTROCARDIOGRAPHIC PATTERNS OF SUDDEN CARDIAC DEATH IN A PATIENT WITH MYOCARDIAL INFARCTION AND COMMUNITY-ACQUIRED PNEUMONIA CAUSED BY THE NEW CORONAVIRUS INFECTION

Abstract. Introduction. Sudden death remains a major public health problem causing death in 25–50% of patients with a previous myocardial infarction. Studying and searching for new prognostic risk factors for sudden cardiac death are an extremely difficult task. Atrioventricular dissociation may be one of the significant cardiac complications of acute myocardial infarction in a patient diagnosed with a new coronavirus infection. Aim was to present a clinical case of patient G. born in 1936 with sudden cardiac death registered during 24-hour electrocardiography monitoring, which was preceded by arrhythmogenic myocardial activity and atrioventricular dissociation. Materials and Methods. Literature was reviewed, and patient G.’s medical background was studied. Results and Discussion. Changes are shown that took place in the in arrhythmogenic myocardial activity preceding asystole in patient G. born in 1936, who was hospitalized with a diagnosis of coronary heart disease. Repeated myocardial infarction of the inferior wall of the left ventricle dated November 11, 2023. Post-infarction cardiosclerosis (1986). Rhythm and conduction disturbances are a paroxysmal form of atrial fibrillation. First-degree atrioventricular block, complete right bundle branch block. Hypertension stage 3, risk 4. Controlled arterial hypertension. Target blood pressure 120-129/70-79 mm Hg. Hypertrophy of the walls and dilatation of the cavities of the left ventricle and of the left and right atria. Chronic heart failure 2B (Simpson ejection fraction 29%). Functional class III. Bilateral hydrothorax. Community-acquired right-sided pneumonia, severe. Respiratory failure 1-2. Type 2 diabetes mellitus, target glycated hemoglobin level below 8%. Chronic kidney disease C3a (glomerular filtration rate 55 ml/min/1.73 m²). New coronavirus infection (PCR SARS-COV-2 diagnosed on November 21, 2023). Conclusions. In the presented case report, electrophysiological instability of the myocardium preceding asystole in patient G. was recorded on a long-term electrocardiogram recording, the patient having the verified leading risk factors for sudden cardiac death, such as hemodynamically significant ventricular arrhythmias, myocardial infarction, episodes of atrioventricular dissociation, heart failure with the reduced left ventricular ejection fraction, and coronavirus infection.