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Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report
RATIONALE: Idiopathic ventricular tachycardia (VT) occurs in individuals without structural abnormalities in the heart, accounts for approximately 10% of total VTs. Furthermore, approximately 70% of idiopathic VTs originate from Right ventricular outflow tract (RVOT). However, among perioperative ar...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238283/ https://www.ncbi.nlm.nih.gov/pubmed/34160410 http://dx.doi.org/10.1097/MD.0000000000026372 |
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author | Park, Ki Hyun Lim, Hyun Kyoung Kim, Na Eun Shinn, Helen Ki Baek, Yong Soo |
author_facet | Park, Ki Hyun Lim, Hyun Kyoung Kim, Na Eun Shinn, Helen Ki Baek, Yong Soo |
author_sort | Park, Ki Hyun |
collection | PubMed |
description | RATIONALE: Idiopathic ventricular tachycardia (VT) occurs in individuals without structural abnormalities in the heart, accounts for approximately 10% of total VTs. Furthermore, approximately 70% of idiopathic VTs originate from Right ventricular outflow tract (RVOT). However, among perioperative arrhythmias, incidence of VT after surgery is extremely rare and most arrhythmias are atrial origin. PATIENT CONCERNS: A 69-year-old man with permanent pacemaker underwent colon surgery. DIAGNOSES: Patient suffered from low blood pressure and dizziness, sweating at post anesthetic care unit (PACU) and heart rate (HR) increased suddenly to 200 beats/min with monomorphic VT after bolus ephedrine administration and continuous dopamine infusion. INTERVENTIONS: Pacemaker interrogation followed by DC cardioversion was done. OUTCOMES: Patient's vital signs became normal and symptoms are subsided. LESSONS: RVOT VT can be caused by triggering activities, such as ephedrine, dopamine, and inadequate fluid management. These triggering activities are initiated by acceleration of HR from ventricles with infusion of catecholamine which lead monomorphic VT originating from RVOT. RVOT origin PVCs can be precipitated into monomorphic VT by administrating catecholamines such as ephedrine and dopamine even in patient with pacemaker. The mechanism of these VTs includes catecholamine induced acceleration of HR. Since RVOT PVCs can be recognize by 12 EKGs, we should be pay more attentions to the pre-operation EKG and be cautious using catecholamines. |
format | Online Article Text |
id | pubmed-8238283 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-82382832021-07-06 Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report Park, Ki Hyun Lim, Hyun Kyoung Kim, Na Eun Shinn, Helen Ki Baek, Yong Soo Medicine (Baltimore) 3300 RATIONALE: Idiopathic ventricular tachycardia (VT) occurs in individuals without structural abnormalities in the heart, accounts for approximately 10% of total VTs. Furthermore, approximately 70% of idiopathic VTs originate from Right ventricular outflow tract (RVOT). However, among perioperative arrhythmias, incidence of VT after surgery is extremely rare and most arrhythmias are atrial origin. PATIENT CONCERNS: A 69-year-old man with permanent pacemaker underwent colon surgery. DIAGNOSES: Patient suffered from low blood pressure and dizziness, sweating at post anesthetic care unit (PACU) and heart rate (HR) increased suddenly to 200 beats/min with monomorphic VT after bolus ephedrine administration and continuous dopamine infusion. INTERVENTIONS: Pacemaker interrogation followed by DC cardioversion was done. OUTCOMES: Patient's vital signs became normal and symptoms are subsided. LESSONS: RVOT VT can be caused by triggering activities, such as ephedrine, dopamine, and inadequate fluid management. These triggering activities are initiated by acceleration of HR from ventricles with infusion of catecholamine which lead monomorphic VT originating from RVOT. RVOT origin PVCs can be precipitated into monomorphic VT by administrating catecholamines such as ephedrine and dopamine even in patient with pacemaker. The mechanism of these VTs includes catecholamine induced acceleration of HR. Since RVOT PVCs can be recognize by 12 EKGs, we should be pay more attentions to the pre-operation EKG and be cautious using catecholamines. Lippincott Williams & Wilkins 2021-06-25 /pmc/articles/PMC8238283/ /pubmed/34160410 http://dx.doi.org/10.1097/MD.0000000000026372 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 3300 Park, Ki Hyun Lim, Hyun Kyoung Kim, Na Eun Shinn, Helen Ki Baek, Yong Soo Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title | Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title_full | Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title_fullStr | Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title_full_unstemmed | Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title_short | Ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: A case report |
title_sort | ventricular tachycardia of right ventricular outflow tract origin during the perioperative period: a case report |
topic | 3300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238283/ https://www.ncbi.nlm.nih.gov/pubmed/34160410 http://dx.doi.org/10.1097/MD.0000000000026372 |
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