Öz
A 57-year-old housewife was admitted to the emergency department with a 2-hour history of palpitations and acute dyspnea. Upon detailed examination of her medical history, it was found that she had been suffering from tachycardia attacks lasting 10-15 minutes for six months and been receiving anti-depressant therapy for ten years. Her electrocardiogram (ECG) indicated ventricular tachycardia (VT), which rapidly changed to sinus rhythm with cardioversion. Clomipramine therapy was ceased as QTc was calculated as 600 ms. At the initial 3-day follow-up, the rhythm of the patient who had three times attacks was converted to sinus rhythm with cardioversion. Later, the QTc value of the patient who had no VT attack was evaluated as 420 ms in her ECG which was analyzed at the end of the first week of her hospitalization. The patient was discharged from the hospital on the fifteenth day of her hospitalization. We present a case of VT from use of clomipramine at therapeutic dosage.
Anahtar Kelimeler
Kaynakça
- Ramanathan KB, Davidson C. Cardiac arrhythmia and imipramine therapy. Br Med J. 1975;1:661-2.
- Boehnert MT, Lovejoy FH Jr. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med 1985;313:474-9.
- Buckley NA, Chevalier S, Leditschke IA, O'Connell DL, Leitch J, Pond SM. The limited utility of electrocardiography variables used to predict arrhythmia in psychotropic drug overdose. Crit Care 2003;7:R101-7.
- Ohtani H, Odagiri Y, Sato H, Sawada Y, Iga T. A comparative pharmacodynamic study of the arrhythmogenicity of antidepressants, fluvoxamine and imipramine, in guinea pigs. Biol Pharm Bull 2001;24:550-4.
Öz
57 yaşında kadın 2 saattir devam eden çarpıntı ve nefes darlığı şikayeti ile başvurdu. Hastanın hikayesi sorgulandığında, çarpıntı ataklarının 6 aydır olduğu, 10-15 dakika sürüp geçtiği ve on yıldır antidepresan tedavi aldığı öğrenildi. Hastanın elektrokardiyogramındaki ventriküler taşikardi (VT) mevcuttu ve kardiyoversiyonla hızlı bir şekilde sinüs ritmine döndürüldü. QTc mesafesi 600 ms olarak ölçülmesi üzerine Klomipramin tedavisi kesildi. Takibinin ilk 3 gününde 3 kez oluşan ventriküler taşikardi atağı kardiyoversiyon ile sinüs ritmine döndürüldü. Hastanın yatışının ilk haftasının sonunda QTc mesafesi 420 ms olarak ölçüldü ve sonrasında hiç VF atağı olmadı. Hasta yatışının onbeşinci günü hasteneden taburcu edildi. Biz tedavi dozunda klomipramin kullanımına bağlı bir VT olgusunu sunmak istedik
Anahtar Kelimeler
Kaynakça
- Ramanathan KB, Davidson C. Cardiac arrhythmia and imipramine therapy. Br Med J. 1975;1:661-2.
- Boehnert MT, Lovejoy FH Jr. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med 1985;313:474-9.
- Buckley NA, Chevalier S, Leditschke IA, O'Connell DL, Leitch J, Pond SM. The limited utility of electrocardiography variables used to predict arrhythmia in psychotropic drug overdose. Crit Care 2003;7:R101-7.
- Ohtani H, Odagiri Y, Sato H, Sawada Y, Iga T. A comparative pharmacodynamic study of the arrhythmogenicity of antidepressants, fluvoxamine and imipramine, in guinea pigs. Biol Pharm Bull 2001;24:550-4.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Nisan 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 5 Sayı: 3 |