open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28
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Electrocardiogram of the month
Polymorphic ventricular tachycardia in acute myocardial infarction without ST elevation in a patient with thrombocytopenia

Piotr Kukla, Leszek Bryniarski, Jacek Dragan, Teresa Słowiak-Lewińska, Marcin Czamara, Alicja Bromblik, Kazimierz Szczuka
Kardiol Pol 2006;64(9):1008-1013.

open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28

Abstract

67-year-old woman with thrombocytopenia (treated with prednisolon and azathiopryn) was admitted because of acute myocardial infarction without ST segment elevation (NSTEMI). From the 2nd day we observed increasing QTc interval from 461 ms with normal potassium level. Suddenly on the 6th day of the so far uncomplicated AMI ventricular fibrillation developed and was succesfully treated with DC shock, and amiodarone (150 mg i.v.) was administred because of recurrent NSVT. Potassium level was 2.9 mmol/l. Within the next 2 days in the morning hours we observed episodes of reccurent polymorphic ventricular tachycardia (PMVT), always progressing into ventricular fibrillation (VF). The ECG showed QT interval – 520 ms, QTc – 602 ms. The patient was given an increasing dose of b-blocker and lidokaine in i.v. infusion. After this regimen PMVT/VF did not recur and QT was normalized. Additionally successful PCI of LAD with 80% stenosis was performed. The paper discusses the problem of PMVT in the settings of AMI.

Abstract

67-year-old woman with thrombocytopenia (treated with prednisolon and azathiopryn) was admitted because of acute myocardial infarction without ST segment elevation (NSTEMI). From the 2nd day we observed increasing QTc interval from 461 ms with normal potassium level. Suddenly on the 6th day of the so far uncomplicated AMI ventricular fibrillation developed and was succesfully treated with DC shock, and amiodarone (150 mg i.v.) was administred because of recurrent NSVT. Potassium level was 2.9 mmol/l. Within the next 2 days in the morning hours we observed episodes of reccurent polymorphic ventricular tachycardia (PMVT), always progressing into ventricular fibrillation (VF). The ECG showed QT interval – 520 ms, QTc – 602 ms. The patient was given an increasing dose of b-blocker and lidokaine in i.v. infusion. After this regimen PMVT/VF did not recur and QT was normalized. Additionally successful PCI of LAD with 80% stenosis was performed. The paper discusses the problem of PMVT in the settings of AMI.
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Keywords

polymorphic ventricular tachycardia; QT interval; NSTEMI; myocardial infarction

About this article
Title

Electrocardiogram of the month
Polymorphic ventricular tachycardia in acute myocardial infarction without ST elevation in a patient with thrombocytopenia

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 9 (2006)

Pages

1008-1013

Published online

2006-10-11

Bibliographic record

Kardiol Pol 2006;64(9):1008-1013.

Keywords

polymorphic ventricular tachycardia
QT interval
NSTEMI
myocardial infarction

Authors

Piotr Kukla
Leszek Bryniarski
Jacek Dragan
Teresa Słowiak-Lewińska
Marcin Czamara
Alicja Bromblik
Kazimierz Szczuka

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