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Cardiac dysrhythmias in systemic sclerosis / Alteraciones del ritmo cardíaco en esclerosis sistémica
Department of General Anesthesiology and Department of Outcomes ResearchKhanna, Sandeep; Department of Cardiothoracic Anesthesiology and Department of General AnesthesiologyTrombetta, Carlos.
  • Department of General Anesthesiology and Department of Outcomes ResearchKhanna, Sandeep; Cleveland Clinic Foundation. Anesthesiology Institute. Department of General Anesthesiology and Department of Outcomes ResearchKhanna, Sandeep. Cleveland. US
  • Department of Cardiothoracic Anesthesiology and Department of General AnesthesiologyTrombetta, Carlos; Cleveland Clinic Foundation. Anesthesiology Institute. Department of Cardiothoracic Anesthesiology and Department of General AnesthesiologyTrombetta, Carlos. Cleveland. US
Rev. colomb. anestesiol ; 49(3): e500, July-Sept. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1280182
ABSTRACT
Systemic sclerosis is an immunological disorder characterized by tissue fibrosis and multi-organ dysfunction.1 The accompanying images exhibit electrocardiographic changes in severe systemic sclerosis. Advanced 31 atrioventricular block, best observed in Lead Vi, suggests extensive fibrosis of the conduction system (Image A). While one P wave is buried in the T wave (black arrows), two are evident (red arrows) along the isoelectric line. Bradyarrhythmia related prolonged QT interval, best measured in Lead II represents increased risk for torsades-de-pointes, a polymorphic ventricular tachyarrhythmia. Additionally, right bundle branch block with giant T wave inversions (T wave depth > 10 mm) in precordial leads V2- 4 suggests pulmonary hypertension. Post-induction the rhythm abruptly changes to torsades-de-pointes (Image B) necessitating defibrillation.
RESUMEN
La esclerosis sistémica es un trastorno inmunológico caracterizado por fibrosis tisular y disfunción multiorgánica. 1 Las imágenes adjuntas muestran cambios electrocardiográficos en la esclerosis sistémica grave. El bloqueo auriculoventricular avanzado 3 1, que se observa mejor en la derivación VI, sugiere una fibrosis extensa del sistema de conducción ( Imagen A ).Mientras que una onda P está enterrada en la onda T (flechas negras), dos son evidentes (flechas rojas) a lo largo de la línea isoeléctrica. El intervalo QT prolongado relacionado con bradiarritmia, mejor medido en la derivación II, representa un mayor riesgo de torsades-de-pointes, una taquiarritmia ventricular polimórfica. Además, el bloqueo de la rama derecha del haz con inversiones de la onda T gigante (profundidad de la onda T> 10 mm) en las derivaciones precordiales V2- 4 sugiere hipertensión pulmonar. Después de la inducción, el ritmo cambia abruptamente a torsades-de-pointes ( Imagen B ), lo que requiere desfibrilación.
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Full text: Available Index: LILACS (Americas) Main subject: Arrhythmias, Cardiac / Scleroderma, Systemic / Electrocardiography Type of study: Etiology study / Risk factors Limits: Humans Language: English Journal: Rev. colomb. anestesiol Journal subject: Anesthesiology Year: 2021 Type: Article Affiliation country: United States Institution/Affiliation country: Cleveland Clinic Foundation/US

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Full text: Available Index: LILACS (Americas) Main subject: Arrhythmias, Cardiac / Scleroderma, Systemic / Electrocardiography Type of study: Etiology study / Risk factors Limits: Humans Language: English Journal: Rev. colomb. anestesiol Journal subject: Anesthesiology Year: 2021 Type: Article Affiliation country: United States Institution/Affiliation country: Cleveland Clinic Foundation/US