When you only live twice

Article Abstract:

The case of a 22-year-old man who had a cardiac arrest illustrates the challenge of diagnosing and treating this condition in healthy young people. He suddenly lost consciousness and was taken to a hospital where he was found to be in ventricular fibrillation. CPR restored his heart function and an ECG revealed an arrhythmia called a right bundle branch block. Neither he nor any family members had a history of heart disease. During an exercise test, he developed a rapid heart beat (tachycardia), which resolved spontaneously. Heart catheterization revealed normal coronary arteries and a biopsy of heart muscle was also normal. However, under electrophysiologic stimulation, the patient developed ventricular tachycardia which progressed to ventricular fibrillation. His heart function was restored once again, and his doctors found that his arrhythmia did not respond to anti-arrhythmic drugs. He was treated with an implanted defibrillator and beta blockers.

Case studies, Sudden death, Ventricular tachycardia

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Aminophylline for bradyasystolic cardiac arrest refractory to atropine and epinephrine

Article Abstract:

Aminophylline may be effective for the resuscitation of patients suffering from bradyasystolic cardiac arrest who have failed to respond to other drugs. Bradyasystolic cardiac arrest is a form of cardiac arrest characterized by bradyarrhythmia, or irregular heartbeat. A study examined the effect of aminophylline in 15 patients suffering bradyasystolic cardiac arrest who failed to respond to epinephrine or atropine. Eleven patients developed a stable heart rhythm within 30 seconds of treatment, and four did not respond to treatment. All the patients who responded to treatment were alive one hour later, but 10 died within four hours to 15 days after resuscitation. Eight patients died from cardiogenic shock after being resuscitated, and two died from brain damage caused by oxygen deficiency. Less than 3% of patients survive after suffering from bradyasystolic cardiac arrest.

Health aspects, Drug therapy, Bradycardia, Cardiac arrest, Aminophylline

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QT or not QT?

Article Abstract:

Pheochromocytoma can cause the long-QT syndrome. Pheochromocytoma is a tumor of the adrenal glands. When a 35-year-old woman was admitted to a hospital with heart palpitations and a history of fainting, her doctors initially suspected that she had long-QT syndrome. This is a type of heart arrhythmia. They treated her with beta blockers and a pacemaker but her arrhythmia got worse and she went into cardiac arrest. Her blood pressure dropped each time she got out of bed, which led the doctors to suspect pheochromocytoma. A CT of her abdomen revealed a tumor on her right adrenal gland. Her arrhythmia stopped when the tumor was removed.

Diagnosis, Causes of, Arrhythmia, Pheochromocytoma

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