Europace 2008 10(1):77-78; doi:10.1093/europace/eum281
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org.
EHRA EDUCATION COMMITTEE
Case of polymorphic ventricular tachycardia after stroke necessitating defibrillation
Isabelle C. Van Gelder on behalf of the EHRA Education Committee1,2,,
Giuseppe Boriani3,
Sabine Ernst4,
Hein Heidbuchel5,
Antonio Zaza6,
Markku Mäkijärvi7,
Bulent Gorenek8,
Carina Blomström Lundquist9
1 Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands;
2 Interuniversity Cardiology Institute Netherlands, Utrecht, The Netherlands;
3 Institute of Cardiology, University of Bologna, Bologna, Italy;
4 Department of Cardiology, Royal Brompton Hospital, London, UK;
5 Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium;
6 Department di Biotecnologie e Bioscienze, University of Milano-Bicocca, Milano, Italy;
7 Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland;
8 Eskisehir Osmangazi University, Eskisehir, Turkey;
9 Department of Cardiology, University Hospital Uppsala, Uppsala, Sweden
* Corresponding author. Tel: +31 50 3612355; fax: +31 50 3614391. E-mail address: i.c.van.gelder{at}thorax.umcg.nl
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Abstract
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This case describes the occurrence of a tachycardia occurring
early after a subarachnoid haemorrhage.
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Introduction
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A 68-year-old female patient was admitted to the stroke unit
of our hospital because of severe headache followed by loss
of consciousness. Computer tomography of the cerebrum revealed
the presence of a subarachnoid haemorrhage by a ruptured anterior
communicating artery aneurysm. An emergency craniotomy for aneurysm
clipping was scheduled. She was haemodynamically stable. She
had no cardiac history of heart failure, myocardial infarction/ischaemia,
or arrhythmias. She was treated with enalapril 20 mg daily for
hypertension.
While waiting for surgery, she developed sustained tachycardias (Figure 1) necessitating defibrillation twice. The electrocardiogram after the first defibrillation is shown in Figure 2.
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Questions
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- What type of tachycardia is depicted in Figure 1?
- What is abnormal in the 12-lead electrocardiogram shown in Figure 2?
- What should be checked and which laboratory tests are essential to perform ?
- What other tests should be performed?
- What is the therapy in the acute situation?
- What is the cause of the tachycardia?
For answers see page 124
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Abstract
Introduction
