Epinephrine-Induced Polymorphic Ventricular Tachycardia in a Patient With Congenital Long QT Syndrome.
10.4070/kcj.2009.39.9.386
- Author:
Jae Hee KIM
1
;
Sun Hee PARK
;
Kyun Hee KIM
;
Won Suk CHOI
;
Jung Kyu KANG
;
Na Young KIM
;
Yongkeun CHO
Author Information
1. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. choyk@mail.knu.ac.kr
- Publication Type:Case Report
- Keywords:
Long QT syndrome;
Epinephrine;
Ventricular tachycardia
- MeSH:
Echocardiography;
Electrocardiography;
Epinephrine;
Female;
Heart Diseases;
Humans;
Long QT Syndrome;
Nevus;
Nose;
Shock;
Sports;
Stress, Psychological;
Surgery, Plastic;
Syncope;
Tachycardia, Ventricular;
Young Adult
- From:Korean Circulation Journal
2009;39(9):386-388
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 24-year-old woman presented to the department of plastic surgery for surgical excision of a nevus on her nose. Although her history failed to reveal any cardiac disease, her pre-operative electrocardiogram (ECG) showed an extremely prolonged QT interval of up to 528 msec. Repeated history-taking after admission revealed three syncopal episodes associated with both physical and emotional stress, and because the two-dimensional echocardiography and exercise ECG test were normal except for the prolonged QT interval, an epinephrine test was done to assess QT interval changes after an epinephrine infusion. Immediately after a bolus injection of epinephrine (0.1 microgram/kg), marked prolongation of the QT interval developed, followed by polymorphic ventricular tachycardia which was immediately terminated with direct current shock, resulting in the diagnosis of a long QT syndrome (LQTS), probably type 1. Gene studies were recommended, but declined by the patient and her family. She was instructed to avoid competitive sports, and a beta-blocker was prescribed after which she remained symptom-free.
