Heart to heart illness for mother and daughter

Revathy.P*

Emergency Ward Incharge, Kauvery Hospital, Heartcity, Trichy, Tamil Nadu

*Correspondence

Abstract

A case of mother (85yrs/f) and daughter (49yrs/f), primarily to ER at 08.00am mother came with the complaints of giddiness since 2days aggravated since 09.02.2026 morning known systemic hypertension /no other significant medical history or family history, patient initially went to specialty and came here for further management on further evaluation, ECG showed complete heart block and advised for TPI followed PPI. Patients not willing for admission and further management, they want to get treated in their hometown hospital. (kumbakonam). Also her daughter presented with complaints of left arm pain since 2 hours, on evaluation ECG showed NSTEMI changes and advised for coronary Angiogram and further management but she also wanted to consult in their nearby hometown hospital, both patients wanted went on AMA despite adequate counseling the consultant and ER Team to them and their attender over phone.

Key words: Non-ST-elevation myocardial infarction (NSTEMI); Complete heart block (CHB)

Introduction

Based on the query “Heart to heart illness for mother and daughter complete heart block and NSTEMI,” there is no specific, widely published, single case report or medical abstract, pair and mother and daughter suffering simultaneously from complete heart block (CHB) and Non-ST-elevation myocardial infarction (NSTEMI) as a “heart-to-heart” or “cardiac bond” case. Mother had complete heart block, Daughter had Non -ST-elevation Myocardial infarction (which required immediate intervention.

Case Presentation

Mother is a known case of systemic hypertension since 15yrs on regular medical management. Daughter is a known case systemic hypertension 2 years, type 2 diabetic mellitus since 3yrs on regular medical management and also had undergone s/p hysterectomy 2yrs back , s/p right mastectomy (2021)

Relevant clinical Findings

Mother- Conscious and oriented
CVS	S1S2+
RS	BAE+
PA	Soft NAD
CNS	Moves all four limbs/No neuro deficit
Pupil	PEARL
GCS	15
BMI	24.1(Overweight range)

Daughter- Conscious and oriented
CVS	S1S2+
RS	BAE+
PA	Soft NAD
CNS	Moves all four limbs/No neuro deficit
Pupil	PEARL
GCS	15
BMI	24.0(Over weight range)

Relevant investigations and Results

ECG Report
Mother	ECG Showed Complete heart block
Daughter	ECG showed ST Depression in V1 to V5
Echocardiogram
Mother	Good LV Function, No RWMA
Daughter	Mild LV Function, LAD Hypokinesia
Diagnosis
Mothers Diagnosis	Complete heart block, systemic hypertension
Daughter Diagnosis	Non -ST-elevation Myocardial infarction

Nursing Management

Mother’s Management – Monitor vital signs

HR	27/Mts
BP	150/60mmhg
RR	22/mts
SPO2	97%
Temp	98.6f
CBG	125mg/dl
GCS	15/5
Pain Score	0/10

Check for altered mental status, Chest pain, shortness of breath or cold/clammy skin
Cardiac monitoring
IV-line Access
Plan: CCU admission Temporary pacemaker and permanent pacemaker
Patient mental conditioning
Patient not willing for further management Went to AMA Discharged

Daughter Management: Monitor vital signs

HR	84/mts
BP	140/90mmhg
RR	20/mts
SPO2	97%
Temp	98.6f
CBG	206mg/dl
GCS	15/5
Pain score	2/10

Check for altered mental status, Chest pain, shortness of breath, or cold/clammy skin
Cardiac motioning.
IV line Access.
Patient not willing for further management Went to AMA Discharged.
Plan: Critical care admission and Coronary Angiogram and adequate counseling.

Conclusion

This is an extraordinary and unusual clinical scenario. Having one family member with a Complete Heart Block (CHB) While the other suffers an NSTEMI (Non -ST Elevation Myocardial Infarction)creates a high -stakes medical situation that requires looking at both individual pathology and potential shared links. Probably if accompanied couple of normal or healthy attender things would have been different to their safety.

Mother A:Complete Heart Block(CHB): This is a “rhythm” or electrical issues. The electrical signals from the heart’s upper chambers (atria) fail to reach the lower chambers (ventricles). This usually requires an emergency pacemaker. Primary happens when patient in hypotension and cardiogenic shock

Daughter B:NSTEMI

This is a “plumbing” or blood flow issue. A coronary artery partially blocked, leading to heart muscle damage (detected by elevated troponin levels) but without the total “ST-elevation” seen in a classic massive heart attack.

We had followed up the patient through phone call Mother undergone treatment in nearby GH (Kumbakonam) and admitted there, treatment was ongoing, for daughter, she underwent coronary angiogram and advised for medical management and been discharged, both are stable as per attenders’ statement.

“Early Action Today Ensures More Tomorrows”

Heart to heart illness for mother and daughter

Heart to heart illness for mother and daughter

Revathy.P*

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