Flecainide is a class 1C antiarrhythmic drug especially used for the management of supraventricular arrhythmia. In overdose cases, flecainide can induce life treating ventricular arrhythmias and cardiogenic shock. We report the case of a 72-year-old woman admitted to our intensive care unit for a regular monomorphic wide complex tachycardia (QRS duration 240 ms, right bundle branch block and superior axis morphology) without apparent P waves. Clinical examination showed slight left congestive heart failure signs without cardiogenic shock. An intravenous bolus of 10 mg adenosine 5'-triphosphate (ATP) was ineffective to stop the tachycardia. The diagnosis of ventricular tachycardia induced by flecainide overdose was considered. 500 mL of intravenous 84‰ sodium bicarbonate was administrated. The patient's QRS narrowed immediately and 12-lead ECG showed sinus rhythm. Blood samples confirmed the flecainide overdose and the clinical status progressively improved.
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http://dx.doi.org/10.5603/CJ.2013.0035 | DOI Listing |
Kardiol Pol
December 2024
Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
Cardiogenic shock (CS) in women is a serious cardiovascular (CV) event associated with a high mortality rate. Non-ischemic etiologies are the most common etiologies in women, such as stress-induced cardiomyopathy, peripartum/postpartum cardiomyopathy, heart failure-related CS, or CS due to myocarditis or valvular heart disease. Although not being the most common etiology in women, acute myocardial infarction is still an important one.
View Article and Find Full Text PDFDiscoveries (Craiova)
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Interventional Cardiologist, Apollo Hospitals Chennai Greams Road, India.
This case report examines a rare cardiovascular abnormality, the Aberrant Aortic Origin of the Right Coronary Artery (AAORCA), in a 75-year-old patient with a history of myocardial infarction, acute renal injury, and cardiogenic shock. Rapid medical intervention, including coronary angioplasty, demonstrated the significance of prompt care. Chronic issues, including tobacco use and left ventricular dysfunction, complicated matters, emphasizing the importance of comprehensive long- term therapy.
View Article and Find Full Text PDFJ Cardiothorac Surg
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Department of Critical Care, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000, China.
Background: Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is commonly used for patients with cardiac arrest, cardiogenic shock, or heart failure and is a life-saving technique. Computed tomography angiography (CTA) examination in patients on ECMO presents certain challenges. Due to the dual circulation characteristics of blood flow in ECMO patients, vascular imaging and interpretation can be difficult and may even present pitfalls.
View Article and Find Full Text PDFJ Cardiothorac Surg
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Department of Cardiovascular Surgery, Kanazawa University, Takaramachi 13-1, Kanazawa, 920-8641, Japan.
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View Article and Find Full Text PDFJACC Adv
December 2024
TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Acute decompensated valvular disease encompasses a group of complex and challenging conditions, which are often the primary reason for admission to the cardiac intensive care unit and can also complicate the management of other primary cardiac disorders. Critically ill patients with valvular disease also present unique diagnostic and management challenges. Historically, medical and percutaneous interventional therapies have been limited and surgery was the only definitive treatment; however, surgical risk can at times be prohibitive.
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