RESUMO
An 82-year-old female, with left femoral neck fracture was scheduled for left hip hemiarthroplasty, under spinal anaesthesia. She had been suffering from diabetes, hypertension, lung cancer and was previously treated with IV aminophylline for respiratory insufficiency. She was given spinal anaesthesia with 10 mg of 0.5% hyperbaric bupivacaine, and T6 sensory block level was established. After 10 minutes, her blood pressure dropped to 80/60 mmHg, so intravenous ephedrine was given. At that moment, multifocal atrial tachycardia (MAT) appeared on electrocardiogram (ECG). Intravenous infusion of phenylephrine and procainamide was given and conversion of MAT to sinus rhythm was successfully achieved. We report a case of MAT after spinal anaesthesia, in a patient with respiratory insufficiency previously treated with IV aminophylline, which was successfully treated by intravenous infusion of phenylephrine and procainamide.
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Aminofilina , Pressão Sanguínea , Bupivacaína , Eletrocardiografia , Efedrina , Fraturas do Colo Femoral , Hemiartroplastia , Quadril , Hipertensão , Infusões Intravenosas , Neoplasias Pulmonares , Fenilefrina , Procainamida , Insuficiência Respiratória , Estresse Psicológico , TaquicardiaRESUMO
Multifocal atrial tachycardia (MAT) is a rare arrhythmia in the newborn. MAT can be difficult to diagnose; it is frequently confused with atrial fibrillation. MAT is difficult to treat but often resolves spontaneously within the first year of life. A newborn with a rapid and irregular pulse rate was diagnosed with multifocal atrial tachycardia by eletrocardiography (ECG) using a hand-made transesophageal electrode. Treatment with propranolol was attempted but ineffective. Treatment with digoxin and sotalol was attempted. The heart rhythm gradually reverted to a sinus rhythm with this treatment. We report our experience managing a neonate with MAT diagnosed by ECG using a hand-made transesophageal electrode.