P165 ARRHYTHMIC STORM IN SUBACUTE MYOCARDIAL INFARCTION: A CASE REPORT
نویسندگان
چکیده
Abstract Introduction Ventricular arrhythmias (VA) represent a common complication of myocardial infarction (MI). Typically, they occur in two scenarios: during acute MI, related to ongoing ischemia, as ventricular tachycardia (VT) or fibrillation (VF), the context late phase presence scar, monomorphic VT (mVT). Despite above, their occurrence may be atypical. Clinical Case 55–year–old man affected by obesity, diabetes and hypertension, admitted our department for subacute MI. Coronarography showed three–vessel disease with indication surgical revascularization. Thirty hours after admission, absence symptoms, cardiovascular arrest due mVT, which degenerated into VF. After resuscitation, ECG Echo findings did not change compared those observed at excluding current ischemia. A blood gas analysis excluded dysionias. Few minutes later, arrhythmic recurrence mVT This was refractory electrical antiarrhythmic therapy stopped only percutaneous left stellate ganglion block (LSGB) deep sedation. Then, emergency revascularization performed. In early postoperative days, weaning attempts from sedation ECMO support, that had become necessary hemodynamic instability surgery, numerous recurrences regressed deepening sedation, multiple external shocks, polytherapy, LSGB. new coronarography documented patency coronary artery bypass grafts. On 6th day, discontinuation circulatory support without VA. The patient discharged intensive care unit started on rehabilitation pathway. Conclusions mVTs are commonly formed ischemia However, it should remembered even might still occur. responsible mechanisms completely known but can assumed that, ischemic event, process scar maturation have led transient proarrhythmic substrate, storm. Further studies needed clarify arrhythmogenesis
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ژورنال
عنوان ژورنال: European Heart Journal Supplements
سال: 2023
ISSN: ['1520-765X', '1554-2815']
DOI: https://doi.org/10.1093/eurheartjsupp/suad111.245