Significant complications can occur with ischemic heart disease and tilt table testing.
We present an elderly patient who had syncope, with known coronary artery disease and a conduction abnormality. Because of a possible vasovagal reaction, the patient underwent a tilt table test prior to evaluation of ischemia or her LV function. During the tilt table test on isoproterenol, the patient developed ventricular fibrillation which was corrected immediately by cardioversion. Subsequently, the patient was found to have significant coronary artery disease which was treated with stenting and angioplasty. After treatment, there were no inducible arrhythmias on full dose isoproterenol. This case reports a significant complication that may occur when tilt table testing with isoproterenol and ischemia.
Leman
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Medical University of South Carolina, Charleston 294225, USA.
Clarke
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Gillette
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D000318:Adrenergic beta-Agonists / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002037:Bundle-Branch Block / Q000150:complications; D003327:Coronary Disease / Q000150:complications / Q000628:therapy; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000009:adverse effects; D017202:Myocardial Ischemia / Q000150:complications*; D015607:Stents; D019462:Syncope, Vasovagal / Q000150:complications; D018667:Tilt-Table Test / Q000009:adverse effects*; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000628:therapy; D018879:Ventricular Premature Complexes / Q000209:etiology / Q000628:therapy
D000318:Adrenergic beta-Agonists; D007545:Isoproterenol