Year 2021, Volume 3 , Issue 2, Pages 91 - 94 2021-07-01

Ketiapin Kullanan bir Hastada WPW Nedenli Ventriküler Taşikardi
WPW Induced Ventricular Tachycardia in a Patient Using Quetiapine

Adem KAYA [1]


Özet Ventriküler taşikardi (VT) birçok neden ile oluşabilen ölümcül bir ritimdir. Wolff Parkinson White (WPW) sendromu VT’ye neden olabilmektedir. Genellikle altta yatan hastalıklara spesifik belirti ve bulgular bulunsa da bazen ayırıcı tanı yapabilmek mümkün olmayabilir. Otuz iki yaşında erkek ani başlayan çarpıntı ve halsizlik şikâyeti ile acile başvurdu. Öyküde ketiapin kullandığı öğrenildi. Fizik bakıda hemodinamisi stabil ve elektrokardiyogramındaki (EKG) ritim VT olarak değerlendirildi. Amiodaron ile medikal kardiyoversiyona başlandı. Takiplerinde bulantı, baş dönmesi ve göğüs ağrısı semptomlarının gelişmesi sonucunda elektriksel kardiyoversiyon uygulanarak normal sinüs ritmine dönüş sağlandı. Kontrol EKG’sinde WPW sendromunu ya da Ketiapin etkisini gösteren tipik bulgular mevcut değildi. Elektrofizyolojik çalışma (EPS) ile WPW tanısı kesinleştirilen hastaya kateter ablasyonu ile başarılı tedavi uygulandı. Ventriküler taşikardi için uygulanan akut medikal tedavi protokollerine yanıt alınamadığı durumlarda elektriksel kardiyoversiyon ön planda düşünülebilir. Ayırıcı tanı ve küratif tedavi için EPS gibi spesifik tedavi prosedürlerinin daha erken uygulanması göz önünde bulundurulabilir.
Abstract Ventricular tachycardia (VT) is a mortal rhythm that can occur for many reasons. Wolff Parkinson White (WPW) syndrome can cause VT. Although there are usually signs and symptoms specific to underlying diseases, sometimes it may not be possible to make a differential diagnosis. A 32-year-old male presented to the emergency department with complaints of sudden onset of palpitations and weakness. He was using quetiapine in history. His hemodynamic were stable and his rhythm on the electrocardiogram (ECG) was evaluated as VT. Medical cardioversion was started with amiodarone. Electrical cardioversion was performed after the development of nausea, dizziness, and chest pain symptoms, and a return to normal sinus rhythm was achieved. There were no typical findings in the control ECG showing WPW syndrome or the effect of Quetiapine. The diagnosis of WPW was confirmed by an electrophysiological study (EPS), and successful treatment was performed by catheter ablation. Early electrical cardioversion may be considered when there is no response to medical cardioversion in the acute treatment of VT. Earlier application of specific treatment procedures such as EPS may be considered for differential diagnosis and curative treatment.
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Primary Language en
Subjects Emergency Medicine, Cardiac and Cardiovascular Systems
Journal Section Case Reports
Authors

Orcid: 0000-0001-9529-1354
Author: Adem KAYA (Primary Author)
Institution: ADANA ŞEHİR HASTANESİ
Country: Turkey


Dates

Application Date : February 18, 2021
Acceptance Date : May 27, 2021
Publication Date : July 1, 2021

AMA Kaya A . WPW Induced Ventricular Tachycardia in a Patient Using Quetiapine. Phnx Med J.. 2021; 3(2): 91-94.