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Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection
BACKGROUND: We report a case of bradycardia improved by surgical resection of the paratracheal lymph nodes, which has rarely been reported in the literature. CASE PRESENTATION: A 41-year-old male patient with pre-operative sinus bradycardia was diagnosed with right upper lobe adenocarcinoma. He plan...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939192/ https://www.ncbi.nlm.nih.gov/pubmed/35317781 http://dx.doi.org/10.1186/s12893-022-01547-6 |
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author | Wei, Jin Yu, Ling Wu, Nan Tan, Hongyu |
author_facet | Wei, Jin Yu, Ling Wu, Nan Tan, Hongyu |
author_sort | Wei, Jin |
collection | PubMed |
description | BACKGROUND: We report a case of bradycardia improved by surgical resection of the paratracheal lymph nodes, which has rarely been reported in the literature. CASE PRESENTATION: A 41-year-old male patient with pre-operative sinus bradycardia was diagnosed with right upper lobe adenocarcinoma. He planned to undergo VATS right upper lobectomy and mediastinal lymph node dissection. Consultation indicated that there was no need to place a temporary pacemaker. Severe sinus bradycardia occurred during induction of anesthesia and heart rate (HR) fell significantly from 52 to 28 bpm. There was no response to atropine. Isoproterenol was administered continuously for two hours at 0.01 µg per kg per minute to keep the patient’s HR around 50 bpm. During the operation, it was noted that the right upper mediastinal lymph nodes (group R2 and R4) were calcified and very close to the vagus nerve. After resection of the lymph nodes, the patient’s HR returned to 60–68 bpm without isoproterenol. There were no post-operative complications and the patient was discharged on the 5th post-operative day. The pathological findings indicated invasive adenocarcinoma with no lymph node metastases. One month after surgery, 24-h Holter monitoring revealed sinus rhythm without bradycardia. Six months after surgery no sinus bradycardia has occurred thus far. CONCLUSIONS: Patients with persistent sinus bradycardia pre-operation caused by vagus nerve compression deserve attention. Guidelines on placement of temporary pacemakers and intraoperative anesthesia management may be improved by additional clinical experience. |
format | Online Article Text |
id | pubmed-8939192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89391922022-03-23 Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection Wei, Jin Yu, Ling Wu, Nan Tan, Hongyu BMC Surg Case Report BACKGROUND: We report a case of bradycardia improved by surgical resection of the paratracheal lymph nodes, which has rarely been reported in the literature. CASE PRESENTATION: A 41-year-old male patient with pre-operative sinus bradycardia was diagnosed with right upper lobe adenocarcinoma. He planned to undergo VATS right upper lobectomy and mediastinal lymph node dissection. Consultation indicated that there was no need to place a temporary pacemaker. Severe sinus bradycardia occurred during induction of anesthesia and heart rate (HR) fell significantly from 52 to 28 bpm. There was no response to atropine. Isoproterenol was administered continuously for two hours at 0.01 µg per kg per minute to keep the patient’s HR around 50 bpm. During the operation, it was noted that the right upper mediastinal lymph nodes (group R2 and R4) were calcified and very close to the vagus nerve. After resection of the lymph nodes, the patient’s HR returned to 60–68 bpm without isoproterenol. There were no post-operative complications and the patient was discharged on the 5th post-operative day. The pathological findings indicated invasive adenocarcinoma with no lymph node metastases. One month after surgery, 24-h Holter monitoring revealed sinus rhythm without bradycardia. Six months after surgery no sinus bradycardia has occurred thus far. CONCLUSIONS: Patients with persistent sinus bradycardia pre-operation caused by vagus nerve compression deserve attention. Guidelines on placement of temporary pacemakers and intraoperative anesthesia management may be improved by additional clinical experience. BioMed Central 2022-03-22 /pmc/articles/PMC8939192/ /pubmed/35317781 http://dx.doi.org/10.1186/s12893-022-01547-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Wei, Jin Yu, Ling Wu, Nan Tan, Hongyu Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title | Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title_full | Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title_fullStr | Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title_full_unstemmed | Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title_short | Severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
title_sort | severe pre-operative sinus bradycardia improved by mediastinal lymph node dissection |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939192/ https://www.ncbi.nlm.nih.gov/pubmed/35317781 http://dx.doi.org/10.1186/s12893-022-01547-6 |
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