TY - JOUR
T1 - A case of torsade de pointes in a patient with severe aortic stenosis during carotid endarterectomy
AU - Nonaka, Hiroko
AU - Tani, Makiko
AU - Kosaka, Makoto
AU - Hatakenaka, Shigeto
AU - Suga, Taro
AU - Kusume, Yoshio
PY - 2013/4
Y1 - 2013/4
N2 - An 87-year-old man with severe aortic stenosis developed torsade de pointes (TdP) during carotid endarterectomy before carotid artery stenosis. By prompt resuscitation and medication including lidocaine and magnesium, the patient recovered without complications in spite of high risk for refractory cardiac arrest or brain infarction. There was no other history or laboratory data suggesting arrhythmia except elongation on preoperative electrocardiogram. Inhaled anesthetics, catecholamine and sympathetic nerve stimulation were possible causes of QT elongation and induce TdP. Particularly in a patient with carotid and cardiac diseases, cardiac arrest is critical. Therefore we should avoid exacerbating factors of QT elongation or TdP even if patients have no particular history of arrhythmia.
AB - An 87-year-old man with severe aortic stenosis developed torsade de pointes (TdP) during carotid endarterectomy before carotid artery stenosis. By prompt resuscitation and medication including lidocaine and magnesium, the patient recovered without complications in spite of high risk for refractory cardiac arrest or brain infarction. There was no other history or laboratory data suggesting arrhythmia except elongation on preoperative electrocardiogram. Inhaled anesthetics, catecholamine and sympathetic nerve stimulation were possible causes of QT elongation and induce TdP. Particularly in a patient with carotid and cardiac diseases, cardiac arrest is critical. Therefore we should avoid exacerbating factors of QT elongation or TdP even if patients have no particular history of arrhythmia.
KW - Aortic valve stenosis
KW - Carotid artery stenosis
KW - Carotid endarterectomy
KW - Torsade de pointes
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M3 - Article
C2 - 23697204
AN - SCOPUS:84876304651
VL - 62
SP - 466
EP - 469
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 4
ER -