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Cardiac electrical storm induced by anesthesia was successfully managed during surgery: a case report

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机构: [1]Hebei Med Univ, Dept Anesthesiol, Hosp 4, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China [2]Hebei Med Univ, Dept Gynecol, Hosp 4, Shijiazhuang, Hebei, Peoples R China
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关键词: Ventricular tachycardia (VT) ventricular fibrillation (VF) autotransfusion general anesthesia (GA) case report

摘要:
Background: At present, the overall number of cardiac storms is small, there is a paucity of published literature describing cardiac storms in patients undergoing superficial surgery under general anesthesia (GA). In recent years, cardiac storm has attracted much clinical attention due to its high mortality, difficult management and poor prognosis. Case Description: This paper reports a 57-year-old male with cardiac electrical storm. He presented with clinical symptoms such as exudation, bad breath, restricted mouth opening, and mucous leukoplakia on local skin, without history of cardiac disease and cardiovascular disease, undergoing superficial face surgery under GA. At 2 hours after anesthesia induction, several premature ventricular beats were detected on monitoring. Hematocrit and plasma potassium were found to be markedly decreased. The patient subsequently experienced a cardiac electrical storm, with repeated episodes of polymorphic ventricular tachycardia (VI) not degenerating to ventricular fibrillation (VF). Combining these clinical symptoms and examinations, we made the diagnosis of cardiac electrical storm. At the first occurrence of bradycardia, we administered atropine, which resolved bradycardia. However, this was followed 10 minutes later by VT, which we treated with atropine and epinephrine. Epinephrine and amiodarone were given in the second episode; epinephrine and lidocaine were used to treat the third episode. Finally, he was treated successfully with pharmacologic therapy and chest compressions. No abnormal electrocardiograph events occurred in the patient after surgery. Conclusions: This case highlights the possibility of anesthesia-induced autotransfusion and cardiac electrical storm occurring in patients without known cardiac disease. For this kind of case needs as soon as possible electric defibrillation and electric cardioversion, timely intravenous application effective anti-arrhythmic drugs and other treatment measures. We expect that this case report adds to the existing literature on this subject.

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出版当年[2022]版:
大类 | 4 区 医学
小类 | 4 区 卫生保健与服务
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第一作者机构: [1]Hebei Med Univ, Dept Anesthesiol, Hosp 4, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China
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通讯机构: [1]Hebei Med Univ, Dept Anesthesiol, Hosp 4, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China [*1]Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang 050011, China.
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