Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.

Introduction Sexual dysfunction is rarely studied in Indonesian patients with breast cancer. We aimed to assess the prevalence of sexual dysfunction symptoms following chemotherapy, as well as the pattern and the associated factors. Methods This cross-sectional study included 135 female breast cancer patients receiving primary chemotherapy. The present study measured the prevalence of sexual dysfunction symptoms using an e-questionnaire containing Common Toxicity Criteria for Adverse Events (CTCAE) version 4 at different time points. Other data included sociodemography, clinicopathology, treatment, and other concurrent symptom characteristics. Bivariate and multivariate logistic regression tests were used to analyze any association among variables. Results In the whole panel, 86 (63.7%) of 135 cases experienced sexual dysfunction. The most common symptom was vaginal dryness (45.9%), followed by decreased libido (45.2%), dyspareunia (13.3%), delayed orgasm (11.1%), and anorgasmia (8.9%). When observed at five different time points, the frequency of symptoms increased during chemotherapy and persisted until six months after completing treatment. Chemotherapy duration of >120 days was associated with a higher probability of vaginal dryness (p=0.012) and decreased libido (p=0.033). Spouse age ≥55 years old and body mass index (BMI) ≥23 kg/m 2 were associated with a reduced probability of decreased libido (p=0.033 and 0.025, respectively). The presence of comorbidity was associated with a reduced probability of delayed orgasm (p=0.034). Conclusions A significant proportion of patients with breast cancer had sexual dysfunction following chemotherapy. Vaginal dryness, decreased libido, and dyspareunia were the commonest symptoms observed. Duration of chemotherapy, spouse age, BMI, and comorbidity were associated with the risk of sexual dysfunction occurrence.