RESUMO
We describe a case of 2:1 intermittent preexcitation after adenosine administration in a patient with an accessory pathway that did not show preexcitation on the basal ECG. We review the mechanisms involved that explain this event and the possible utility of adenosine to show accessory pathways that do not show preexcitation on the ECG.
Assuntos
Adenosina/efeitos adversos , Antiarrítmicos/efeitos adversos , Síndromes de Pré-Excitação/induzido quimicamente , Adulto , Eletrocardiografia/efeitos dos fármacos , Feminino , Humanos , Síndromes de Pré-Excitação/fisiopatologia , Taquicardia Paroxística/complicaçõesRESUMO
A 28-year-old female, addict to cocaine and with acute myocardial infraction is reported. The patient was obese and smoked 17 cigarette packs per year. She had been consuming about 250 mg of cocaine daily for the last months until 2 weeks before admission. Coronary angiography showed a 100% stenosis of the left anterior descending artery. Although the vasospastic effect of cocaine on the pathogenesis of coronary ischemia in addicts is well known, most patients reported in the literature show coronary artery stenosis. This may lead to hypothesize about a likely atherogenic role of cocaine.
