Development of torsade de pointes caused by exacerbation of QT prolongation during clipping of cerebral artery aneurysm in a patient with subarachnoid haemorrhage.
We report the case of a 79-yr-old woman with subarachnoid haemorrhage (SAH) in whom torsade de pointes (TdP) caused by worsening the QT prolongation occurred during clipping of cerebral artery aneurysm. This patient shows a potential risk of occurrence of life-threatening tachyarrhythmia, TdP by prolonging the QT interval during surgery in patients with SAH even with no additional factors that predispose to TdP. Therefore, a proper monitoring of the QT interval is necessary as a predictor of TdP. When ventricular tachyarrhythmia occurs, recognition of TdP is important because antiarrhythmic drug therapy for TdP is different from that for ventricular tachyarrhythmias that is not TdP.
Takenaka
I
I
Department of Anaesthesia, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu 805-8508, Japan. takenaka.i@ns.yawata-mhp.or.jp
Aoyama
K
K
Iwagaki
T
T
Ishimura
H
H
Kadoya
T
T
D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications; D008133:Long QT Syndrome / Q000150:complications* / Q000175:diagnosis; D016343:Monitoring, Intraoperative / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D016171:Torsades de Pointes / Q000209:etiology*