RESUMO
We report the case of a 40-year-old man, transferred from another hospital to our ICU because of acute coronary syndrome. Coronarography did not show coronary stenosis. Twenty-four hours monitoring EKG allowed diagnosis of Prinzmetal angina and appropriate therapy was administered. Six months after discharge due recurrence of symptoms, ranolazine was added to therapy. After one year the patient is symptoms free.
Assuntos
Angina Pectoris Variante/diagnóstico , Vasoespasmo Coronário/fisiopatologia , Ranolazina/uso terapêutico , Bloqueadores dos Canais de Sódio/uso terapêutico , Adulto , Assistência ao Convalescente , Angina Pectoris Variante/tratamento farmacológico , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/uso terapêutico , Angiografia Coronária/métodos , Diltiazem/administração & dosagem , Diltiazem/uso terapêutico , Quimioterapia Combinada , Ecocardiografia/métodos , Humanos , Masculino , Ranolazina/administração & dosagem , Recidiva , Bloqueadores dos Canais de Sódio/administração & dosagem , Resultado do TratamentoRESUMO
BACKGROUND: The aim of this study was to report our experience with subcutaneous defibrillator (S-ICD) implantation. METHODS: At our hospital, 7 procedures of S-ICD implantation were performed; 4 of these with ultrasound-guided serratus anterior plane block (SAPB) and 3 with usual local anesthesia followed by sedation. RESULTS: Surgical operations were not burdened with peri- and postprocedural complications, with only one event of limited hematoma of the thoracic wall. Ultrasound-guided serratus anterior plane block was associated with better pain control during the procedure and the postoperative period. The disconnection between latissimus dorsi and serratus obtained by serratus anterior plane block contributed to make the creation of the pocket easier. The technique used is with two incisions. CONCLUSIONS: In our experience, S-ICD implantation with the technique of the serratus anterior plane block is safe and effective, and significantly facilitated pain control during the procedure and postoperatively.