Headache, mild fever, patient suddenly faints due to heartbeat 30 beats/minute

NGUYỄN LY |

Ho Chi Minh City - On August 28, Thu Duc General Hospital announced that it had successfully resuscitated a 27-year-old patient with a heart rate of only about 30 beats per minute.

Patient N.H. T. (born in 1999, residing in Thuan An ward, Ho Chi Minh City) had 2 days prior experienced headache, fatigue and mild fever.

At noon on August 22, the patient suddenly fainted and was taken to the Emergency Department, Thuan An Regional Medical Center. Here, doctors recorded that the patient had 3rd degree atrial atrial blockage, many incoherent spaces, heart rate of about 30 beats/minute, and low blood pressure. The emergency team immediately used atropin and adrenaline to support heart rate and blood pressure.

Recognizing this as a severe heart rhythm disorder, with a life-threatening risk, doctors at Thuan An Regional Medical Center quickly consulted remotely with Thu Duc General Hospital.

Through electrocardiogram analysis and clinical status, doctors agreed to continue on-site emergency treatment with vasopressor drugs, and at the same time prepare to transfer the patient to a facility with in-depth intervention capabilities. By 5 pm on the same day, the patient was transferred to Thu Duc General Hospital.

Here, the rhythm disorder still progressed seriously. The patient continued to have many episodes of inconscience, sometimes with fleeting loss of consciousness.

Doctors quickly placed a temporary pacemaker for emergency treatment. An electrode was delivered through a vein into the right heart chamber, connected to an external pacemaker to maintain the heart rate. After intervention, the heart rate was increased from about 30 to 80 beats/minute, blood pressure and hemodynamic status became more stable. The patient was then given off adrenaline.

The patient was diagnosed with acute myocarditis with 3rd degree atrial septal block and continued to be monitored and treated actively.

After 5 days of treatment, the patient's heart rate recovered, and the clinical condition improved significantly. The pacemaker was temporarily removed and on the 7th day, the patient was eligible for discharge.

BSCKII Le Duy Lac, Head of Cardiovascular Resuscitation and Interventional Cardiology Department, Thu Duc General Hospital, said that acute myocarditis can cause many dangerous complications, in which degree 3 atrial septal block is one of the serious arrhythmia conditions, which can cause fainting, astigmatism and life-threatening.

According to doctors, early identification, timely initial treatment at the grassroots level, combined with remote professional consultation, helps patients to be quickly transferred to facilities with specialized intervention capabilities. In this case, placing a temporary pacemaker plays an important role in maintaining heart rate and stabilizing the patient's condition.

The above case also shows the effectiveness of professional connection between Thuan An Regional Medical Center and Thu Duc General Hospital, from initial emergency care, remote consultation to referral and in-depth intervention.

The coordination activity is implemented according to Decision No. 3412/QD-SYT dated July 17, 2026 of the Ho Chi Minh City Department of Health on assigning Thu Duc General Hospital to support professional development for Thuan An Regional Medical Center.

Accordingly, the two units coordinate in training, consultation, tuyến directing, technical transfer and standardization of professional procedures, gradually improving the capacity of medical examination and treatment at the grassroots level.

NGUYỄN LY
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