[An electrocardiographic abnormality called torsade de pointes in a patient of subarachnoid hemorrhage].
We report the findings in a patient in whom torsade de pointes atypical ventricular tachycardia occurred as a complication of subarachnoid hemorrhage. The patient was a 54-year-old female and she was admitted to our hospital to treat gastric ulcer on October 8, 1985. The electrocardiogram on admission showed mild left ventricular hypertrophy. She complained of severe headache and nausea in hospital on November 10 and she was transferred to our department. Her consciousness was clear. Computed tomography revealed a subarachnoid hemorrhage and left carotid angiogram showed a left middle cerebral artery aneurysm. Laboratory findings of blood and a chest roentgenogram were normal, but the electrocardiogram revealed a prominent prolongation of the QT interval and generalized giant negative T waves. The aneurysm was clipped on November 11, but a torsade de pointes atypical ventricular tachycardia occurred after clipping of the aneurysm during the surgery. Several anti-arrhythmic agents were not effective but phenytoin suppressed the arrhythmia. Postoperative course was almost uneventful. Since she had mild right hemiparesis, she continued the rehabilitation in our department. Five months later her electrocardiographic findings became normal. Prolongation of the QT interval and the giant negative T wave are typical electrocardiographic abnormalities in patients of subarachnoid hemorrhage, causing a predisposition to torsade de pointes ventricular tachycardia. The arrhythmia should be kept in mind as a complication in a viewpoint of the management of subarachnoid hemorrhage in the acute stage.
Amagasa
M
M
Department of Neurosurgery, Yamagata City Hospital Saiseikan, Japan.
Sato
S
S
Suzuki
M
M
Otabe
K
K
D004562:Electrocardiography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D013610:Tachycardia / Q000503:physiopathology*