A successful case of electrical storm rescue after acute myocardial infarction
Abstract Background Electrical storm (ES) is a heterogeneous clinical emergency that can present with malignant ventricular arrhythmias such as ventricular fibrillation (VF), ventricular tachycardia (VT), requiring the need for cardiac defibrillation. ES is a life-threatening condition with a high m...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-022-02982-2 |
| _version_ | 1811188993583218688 |
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| author | Bin Liu Bo Xie Xun Chen Ke Zhu Cheng-Ming Wang Shu-Hong Guo |
| author_facet | Bin Liu Bo Xie Xun Chen Ke Zhu Cheng-Ming Wang Shu-Hong Guo |
| author_sort | Bin Liu |
| collection | DOAJ |
| description | Abstract Background Electrical storm (ES) is a heterogeneous clinical emergency that can present with malignant ventricular arrhythmias such as ventricular fibrillation (VF), ventricular tachycardia (VT), requiring the need for cardiac defibrillation. ES is a life-threatening condition with a high mortality rate. Successfully managing ES in the setting of acute myocardial infarction (MI) is expected to be known by physicians on call to reduce in-hospital mortality. Case presentation A 57-year-old man presenting with acute onset chest pain was found to have an infero-posterior ST-segment elevation myocardial infarction (STEMI) complicated by acute right ventricular MI secondary to total occlusion of the proximal right coronary artery (RCA). The patient developed ES in the form of recurrent VF that was managed successfully with electrical defibrillation, antiarrhythmic therapy with amiodarone and esmolol, endotracheal intubation, sedation, electrolyte replacement, volume resuscitation, comfort care, psychological intervention, and percutaneous coronary intervention (PCI) of the occluded epicardial artery. With these interventions used in quick succession and with the aspiration of a massive RCA thrombus, the patient was reversed to hemodynamic stability, did not have further episodes of VF, and survived the index hospitalization. Conclusion ES is a rare but fatal complication of acute MI. Residents on night shifts should be better prepared and equipped to deal with this rare condition. We hope our successful experience can benefit physicians on call who take care of acute MI patients that deteriorate with ES. |
| first_indexed | 2024-04-11T14:27:35Z |
| format | Article |
| id | doaj.art-34593bda3b89402bb9ca13fb73807efc |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-11T14:27:35Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-34593bda3b89402bb9ca13fb73807efc2022-12-22T04:18:47ZengBMCBMC Cardiovascular Disorders1471-22612022-12-012211710.1186/s12872-022-02982-2A successful case of electrical storm rescue after acute myocardial infarctionBin Liu0Bo Xie1Xun Chen2Ke Zhu3Cheng-Ming Wang4Shu-Hong Guo5First Division, Department of Respiratory and Critical Care Medicine, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalMedical Affairs Department, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalMedical Affairs Department, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalCardiovascular Medicine Department, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalCardiovascular Medicine Department, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalCardiovascular Medicine Department, Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University/Zhuzhou Central HospitalAbstract Background Electrical storm (ES) is a heterogeneous clinical emergency that can present with malignant ventricular arrhythmias such as ventricular fibrillation (VF), ventricular tachycardia (VT), requiring the need for cardiac defibrillation. ES is a life-threatening condition with a high mortality rate. Successfully managing ES in the setting of acute myocardial infarction (MI) is expected to be known by physicians on call to reduce in-hospital mortality. Case presentation A 57-year-old man presenting with acute onset chest pain was found to have an infero-posterior ST-segment elevation myocardial infarction (STEMI) complicated by acute right ventricular MI secondary to total occlusion of the proximal right coronary artery (RCA). The patient developed ES in the form of recurrent VF that was managed successfully with electrical defibrillation, antiarrhythmic therapy with amiodarone and esmolol, endotracheal intubation, sedation, electrolyte replacement, volume resuscitation, comfort care, psychological intervention, and percutaneous coronary intervention (PCI) of the occluded epicardial artery. With these interventions used in quick succession and with the aspiration of a massive RCA thrombus, the patient was reversed to hemodynamic stability, did not have further episodes of VF, and survived the index hospitalization. Conclusion ES is a rare but fatal complication of acute MI. Residents on night shifts should be better prepared and equipped to deal with this rare condition. We hope our successful experience can benefit physicians on call who take care of acute MI patients that deteriorate with ES.https://doi.org/10.1186/s12872-022-02982-2Electrical storm (ES)Myocardial infarction (MI)EsmololPercutaneous coronary intervention (PCI)Thrombus |
| spellingShingle | Bin Liu Bo Xie Xun Chen Ke Zhu Cheng-Ming Wang Shu-Hong Guo A successful case of electrical storm rescue after acute myocardial infarction BMC Cardiovascular Disorders Electrical storm (ES) Myocardial infarction (MI) Esmolol Percutaneous coronary intervention (PCI) Thrombus |
| title | A successful case of electrical storm rescue after acute myocardial infarction |
| title_full | A successful case of electrical storm rescue after acute myocardial infarction |
| title_fullStr | A successful case of electrical storm rescue after acute myocardial infarction |
| title_full_unstemmed | A successful case of electrical storm rescue after acute myocardial infarction |
| title_short | A successful case of electrical storm rescue after acute myocardial infarction |
| title_sort | successful case of electrical storm rescue after acute myocardial infarction |
| topic | Electrical storm (ES) Myocardial infarction (MI) Esmolol Percutaneous coronary intervention (PCI) Thrombus |
| url | https://doi.org/10.1186/s12872-022-02982-2 |
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