Chest
GRAPHIC TECHNIQUES IN CARDIOLOGYResistant Ventricular Tachycardias and Recurrent Cardiac Arrests: 96 Episodes
Section snippets
Case Report
A 66-year-old man with chest pain was admitted to the Swedish-American Hospital on Aug 18, 1973. The initial electrocardiogram and findings from enzymatic studies were normal. On the third day of hospitalization, classic myocardial infarction was confirmed by the ECG and cardiac enzymatic studies. On the next day the patient developed atrial fibrillation requiring administration of digoxin. His course was stable until the 20th day of hospitalization, when he developed severe chest pain and lost
Discussion
As seen in this case, ventricular tachycardia refractory to all known treatment programs remains a challenge requiring therapy individualized to the particular patient. With this patient a multiple drug regimen monitored with determinations of serum drug levels was instituted to no avail. Rapid cardiac pacing2-4 was not beneficial prior to and after ventricular aneurysmectomy. The surgical approach to life-threatening ventricular tachycardia with aneurysmectomy and coronary arterial bypass
Acknowledgments
We wish to thank Robert L. Evans, M.D., and Joseph Pittman, M.D., for their comments on this article. We are indebted also to Burroughs Wellcome Co. of Research Triangle Park, NC, for supplying bretylium tosylate (Bretylate) and G. D. Searle and Co., Chicago, for supplying disopyramide phosphate (Norpace).
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