Aggravation of atrial arrhythmia by amiodarone during the perinatal period: A case report
| Autor: | Yi Wang, Jiang Wenbing, Binglin Pan, Wei Lin, Fanhao Ye, Hao Chen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Tachycardia
Adult medicine.medical_specialty PAROXYSMAL ATRIAL TACHYCARDIA Pregnancy Complications Cardiovascular MEDLINE Amiodarone atrial arrhythmia electrophysiologic study 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy Internal medicine medicine Humans 030212 general & internal medicine cardiovascular diseases Clinical Case Report Tachycardia Paroxysmal Clinical treatment Heart Failure business.industry Arrhythmias Cardiac General Medicine medicine.disease Severe preeclampsia 030220 oncology & carcinogenesis Cardiology cardiovascular system Female medicine.symptom business Perinatal period Anti-Arrhythmia Agents medicine.drug Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Rationale: Amiodarone, a broad-spectrum antiarrhythmic drug, is widely used for the clinical treatment of tachyarrhythmias because of its safety and efficacy. Patient concerns: A 30-year-old woman presented with known paroxysmal atrial tachycardia and severe preeclampsia. Two days before admission, she had given birth to twins. She described her symptoms as a sudden palpitation at 10:20 accompanied by chest tightness and shortness of breath. Diagnosis: Cardiac arrhythmia and acute left heart failure. Interventions: Furosemide and sodium nitroprusside were administered to control the heart failure. At 16:20, 150 mg amiodarone (15 mg/min) was injected intravenously and continued at 1 mg/min. At 16:50, her electrocardiogram showed possible atrial tachycardia or atrial flutter with a ventricular rate of 206 beats/min. Administration of amiodarone was stopped at 17:23, and the medication was changed to esmolol. Outcomes: After 3 minutes, the palpitations stopped, the heart rate changed to a sinus rhythm, and the ventricular rate was 100 beats/min. Four days later, the patient underwent an electrophysiologic study and radiofrequency ablation. Lessons: When amiodarone is used to treat atrial arrhythmia, the ventricular rate may accelerate, which can cause patients with borderline heart failure to develop acute heart failure or further deterioration of acute heart failure. For heart failure induced or mediated by atrial arrhythmias, short-term β-blockers may be used to control the ventricular rate more quickly and effectively and to prevent the progression of heart failure. |
| Databáze: | OpenAIRE |
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