Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm
CASE PRESENTATION This is the case of a 51-year old male without a past medical history. One month before his admission he experienced fast heart palpitations associated with diaphoresis, nausea and vomit. Both the electrocardiogram and the Holter monitor showed recurring episodes of monomorphic ven...
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| Language: | English |
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Permanyer
2020-08-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
| Online Access: | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=243 |
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| author | Piero Custodio-Sánchez Marco A. Peña-Duque Santiago Nava-Townsend Hugo Rodríguez-Zanella Gabriela Meléndez-Ramírez Eduardo A. Arias |
| author_facet | Piero Custodio-Sánchez Marco A. Peña-Duque Santiago Nava-Townsend Hugo Rodríguez-Zanella Gabriela Meléndez-Ramírez Eduardo A. Arias |
| author_sort | Piero Custodio-Sánchez |
| collection | DOAJ |
| description | CASE PRESENTATION This is the case of a 51-year old male without a past medical history. One month before his admission he experienced fast heart palpitations associated with diaphoresis, nausea and vomit. Both the electrocardiogram and the Holter monitor showed recurring episodes of monomorphic ventricular tachycardia (figure 1). The physical examination confirmed the presence of an aortic ejection murmur exacerbated when performing the Valsalva maneuver. The transthoracic echocardiography showed obstructive asymmetric septal hypertrophy with a 32-mm maximum septal diameter (figure 2A), a 65-mmHg gradient in the left ventricular outflow tract, and systolic anterior motion of the mitral valve with moderate regurgitation. The cardiovascular magnetic resonance imaging confirmed the presence of extensive myocardial fibrosis as a risk factor of sudden death (figure 2B and video 1 of the supplementary data). Amiodarone and propranolol were prescribed, and an automatic defibrillator was implanted as a secondary prevention measure. The patient was readmitted to the hospital 4 months later with signs of electrical storm with multiple discharges provided by the device implanted. Deep sedation, mechanical ventilation, and hemodynamic support were administered, and the stellate ganglion was blocked. However, the patient progression was poor with persistent episodes of ventricular tachycardia that triggered the mapping of cardiac... |
| first_indexed | 2024-12-16T12:27:18Z |
| format | Article |
| id | doaj.art-c297af9d42754d1a84f5ac45648d9f21 |
| institution | Directory Open Access Journal |
| issn | 2604-7322 |
| language | English |
| last_indexed | 2024-12-16T12:27:18Z |
| publishDate | 2020-08-01 |
| publisher | Permanyer |
| record_format | Article |
| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj.art-c297af9d42754d1a84f5ac45648d9f212022-12-21T22:31:48ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222020-08-012321922010.24875/RECICE.M19000070Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical stormPiero Custodio-Sánchez0Marco A. Peña-Duque1Santiago Nava-Townsend2Hugo Rodríguez-Zanella3Gabriela Meléndez-Ramírez4Eduardo A. Arias5Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartamento de Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartamento de Resonancia Magnética, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoCASE PRESENTATION This is the case of a 51-year old male without a past medical history. One month before his admission he experienced fast heart palpitations associated with diaphoresis, nausea and vomit. Both the electrocardiogram and the Holter monitor showed recurring episodes of monomorphic ventricular tachycardia (figure 1). The physical examination confirmed the presence of an aortic ejection murmur exacerbated when performing the Valsalva maneuver. The transthoracic echocardiography showed obstructive asymmetric septal hypertrophy with a 32-mm maximum septal diameter (figure 2A), a 65-mmHg gradient in the left ventricular outflow tract, and systolic anterior motion of the mitral valve with moderate regurgitation. The cardiovascular magnetic resonance imaging confirmed the presence of extensive myocardial fibrosis as a risk factor of sudden death (figure 2B and video 1 of the supplementary data). Amiodarone and propranolol were prescribed, and an automatic defibrillator was implanted as a secondary prevention measure. The patient was readmitted to the hospital 4 months later with signs of electrical storm with multiple discharges provided by the device implanted. Deep sedation, mechanical ventilation, and hemodynamic support were administered, and the stellate ganglion was blocked. However, the patient progression was poor with persistent episodes of ventricular tachycardia that triggered the mapping of cardiac...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=243 |
| spellingShingle | Piero Custodio-Sánchez Marco A. Peña-Duque Santiago Nava-Townsend Hugo Rodríguez-Zanella Gabriela Meléndez-Ramírez Eduardo A. Arias Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm REC: Interventional Cardiology (English Ed.) |
| title | Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| title_full | Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| title_fullStr | Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| title_full_unstemmed | Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| title_short | Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| title_sort | bail out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=243 |
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