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Torsades de pointes and myocardial infarction following reversal of supraventricular tachycardia with adenosine: a case report
Paixão, Milena Ribeiro; Ribas, Fernando Faglioni; Accorsi, Tarso Augusto Duenhas; Amicis, Karine De; Souza Jr, José Leão de.
  • Paixão, Milena Ribeiro; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Ribas, Fernando Faglioni; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Accorsi, Tarso Augusto Duenhas; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Amicis, Karine De; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Souza Jr, José Leão de; Hospital Israelita Albert Einstein. Sao Paulo. BR
Einstein (Säo Paulo) ; 22: eRC0522, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1557718
ABSTRACT
ABSTRACT Adenosine is an antiarrhythmic drug that slows conduction through the atrioventricular node and acts as a coronary blood vessel dilator. This case report highlights two unusual life-threatening events following the use of adenosine to revert supraventricular tachycardia in a structurally normal heart non-sustained polymorphic ventricular tachycardia and myocardial infarction. A 46-year-old woman presented to the emergency department with a two-hour history of palpitations and was diagnosed with supraventricular tachycardia. Vagal maneuvers were ineffective, and after intravenous adenosine administration, the patient presented with chest pain and hypotension. The rhythm degenerated into non-sustained polymorphic ventricular tachycardia and spontaneously reverted to sinus rhythm with ST elevation in lead aVR and ST depression in the inferior and anterolateral leads. The patient spontaneously recovered within a few minutes. Despite successful arrhythmia reversal, the patient was admitted to the intensive care unit because of an infarction without obstructive atherosclerosis. This report aims to alert emergency physicians about the potential complications associated with supraventricular tachycardia and its reversal with adenosine.


Full text: Available Index: LILACS (Americas) Language: English Journal: Einstein (Säo Paulo) Journal subject: Medicine Year: 2024 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR

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Full text: Available Index: LILACS (Americas) Language: English Journal: Einstein (Säo Paulo) Journal subject: Medicine Year: 2024 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR