A case report on cerebrogenic fatal cardiac arrhythmia in a patient with acute ischemic stroke
Philippine Journal of Internal Medicine
; : 1-4, 2017.
Article
| WPRIM
| ID: wpr-960107
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND: Patients with acute ischemic stroke are susceptible to cardiac arrhythmias however,fatal arrhythmias are rare in the absence of cardiac disease.Cardiac arrhythmias can develop in lesions at the right side of the brain specifically the insular,frontal and parietal area.Data that show the direct relationship of ischemic stroke and arrhythmia are scarce but they are indirectly attributed to an imbalance in the autonomic nervous system.This paper aims to present a rare case of an association between a fatal arrhythmia and right thalamic infarct. CASE: Presenting a case of a 39-year-old admitted as a survivor of sudden cardiac death from ventricular fibrillation.She presented with a history of left sided weakness a week prior but no work-up was done. Baseline serum electrolytes and cardiac markers were all normal.Electrocardiogram (ECG) post-cardioversion showed sinus tachycardia.Echocardiogram and cardiac computed tomography (CT) angiography were normal. Magnetic resonance imaging (MRI) and angiography (MRA) of the brain showed an acute infarct at the right thalamus and an absent left internal carotid artery (ICA).Electroencephalogram (EEG) was negative.Bisoprolol was given and an Automatic Implantable Cardioverter Defibrillator (AICD) was subsequently placed.No recurrence of cardiac arrhythmia was noted on continuous cardiac telemetry monitoring during her hospitalization and on six months of follow-up.CONCLUSION: Fatal cardiac arrhythmias, can occur in patients with acute thalamic infarct even beyond 24 hours in the presence of other confounding factors despite the absence of cardiac pathology. This case showed the association of heightened autonomic imbalance caused by an acute stroke, decreased cerebral flow, and fatal arrhythmia. This elucidates the importance of cardiac monitoring in acute ischemic stroke. With the paucity of information on serious cardiac arrhythmia and ischemic stroke, a future study on this correlation will be useful.
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Bases de datos:
WPRIM
Asunto principal:
Arritmias Cardíacas
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Sistema Nervioso Autónomo
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Telemetría
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Tálamo
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Fibrilación Ventricular
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Taquicardia Sinusal
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Encéfalo
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Cardioversión Eléctrica
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Angiografía
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Arteria Carótida Interna
Revista:
Philippine Journal of Internal Medicine
Año:
2017
Tipo del documento:
Article