Incessant ventricular tachycardia and Multi-organ failure after inferior STEMI due to Right coronary artery occlusion

Abstract

Inferior wall myocardial infarction (STEMI) is commonly associated with hemodynamic instability and conduction disturbances; however, incessant ventricular tachycardia (VT) as a complication is rare. We report a case of a 66-year-old male with inferior STEMI due to right coronary artery (RCA) occlusion, who developed incessant monomorphic VT, cardiogenic shock, and subsequent multi-organ failure. Despite initial medical therapy, including dual antiplatelet therapy (DAPT), statins, and anticoagulation, the patient’s arrhythmia persisted, necessitating urgent percutaneous coronary intervention (PCI). Post-PCI, the patient experienced cardiogenic shock complicated by acute renal failure, ischemic hepatitis, disseminated intravascular coagulation (DIC), and required hemodialysis. Intensive critical care measures, including mechanical ventilation and renal replacement therapy, led to clinical improvement, and the patient was discharged after 18 days, hemodynamically stable with restored organ function.