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    Mr. Li, Male, 52 years old, was taken to our Hospital because of chest pains for 3 days and abdominal distention for 1 day on May 13th 2004.

    Patient had chest pain, shortness of breath, chills, nausea, vomiting out stomach contents 2 hours after alcohol abuse on 21:00 May 10th 2004. He went to Dongguan Yellow River Hospital, his temperature didn't climb up and this made him feel chilly, HR 26/min, BP undetectable, myocardial enzyme activity enhanced. The diagnosis was "coronary heart disease, acute inferior wall myocardial infarction, atrioventricular block III degree and cardiogenic shock". After normal treatment, the symptoms were relieved and BP rose to 105/64mm Hg. For further treatment, the patient was sent to our Hospital on May 13th 2004.


    Check-up in Clifford Hospital:
    T: 37℃,  P: 45 beats/min,  R: 24 times/min,  BP: 90/58mm Hg, conscious, agitated, obese, slow pulses, distention of jugular vein and positive liver jugular reflux.

    Diagnosis in Clifford Hospital:
    TCM:  Real heart pains
    Western medicine:
    1. Acute inferior wall and myocardium of right ventricle, myocardial infarction
        Grade III atrioventricular block
        Grade IV heart function

    2. Pulmonary infection

    Consciousness disturbance, delirium, irritability were observed when he was admitted into Clifford Hospital. The examinations showed breath 25 times/min, heart rate ranged from 28 to 45 beats/min, blood pressure 85/55 to 102/66mm Hg. The coronary angiography showed: pathological changes of three branches and right coronary occlusion where no blood flowed through. We carried out PCI therapy and the surgery was smooth. The angiography after PCI showed no narrowing. Atrioventricular block turned from type III to type II; ventricle rate 55-72 beats/min. The patient was still unconsciousness and delirious, under which state we could only treat him with integrated therapies of Traditional Chinese and Western medicine. During the recovery treatment period on May 20, 2004, atrioventricular block deteriorated to type III, with no repeated ventricular and A-S syndrome, cardiac arrest occurred twice. We implanted temporary pacemaker after recovery and applied tracheotomy ventilator machine to assist breathing due to breathing difficulties. On May 21 2004, patient recovered sinus rhythm. On May 22, the patient gradually regained consciousness and we stopped the tracheotomy machine. On May 26, 2004, the temporary pacing electrode and tracheotomy tube were removed. He continued to accept comprehensive treatment such as Chinese Medicine, Western Medicine and nutrition diet. On June 18, 2004, Mr Li was discharged.

    In this case, the patient had massive acute myocardial infarction and many complications had appeared:  Atrioventricular block of III degree three times, cardiac arrest, cardiogenic shock, and pulmonary infection etc. The patient was treated by comprehensive therapy integrating modern medical thromblysis, interventional therapy, implanting pacemakers, endotracheal intubation breathing machine, injection of Traditional Chinese medicines Shengmai and Xiangdan, and at the same time, assisted by nutritional diet and Alternative Medicines. With this therapy, he could pull through death.


     


    ECG: Grade III A-V block

    Coronarygraphy

    Two branches of left coronary stenosis      Right coronary artery blocked completely

     
    Right coronary artery recovered to normal after intervention

     
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