Circulation. 2000;101:e81
(Circulation. 2000;101:e81.)
© 2000 American Heart Association, Inc.
Circulation Electronic Pages |
Polymorphic Ventricular Tachycardia and Repolarization Abnormalities Accompanying Intracerebral Hemorrhage
Haim D. Danenberg, MD;
Yonathan Hasin, MD
From the Department of Cardiology, Hadassah University Hospital,
Jerusalem, Israel.
Correspondence to Haim D. Danenberg, Department of Cardiology, Hadassah University Hospital, POB 12000, Jerusalem, Israel 91120. E-mail danen{at}md2.huji.ac.il
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Introduction
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 Top
 Introduction
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A70-year-old
patient with no apparent heart disease was admitted
after a
motor-vehicle accident and had right hemispheric
intracerebral
hemorrhage with compression over
the lateral ventricle (Figure
1
). The
patient was admitted to an intensive care unit, where
an ECG was taken.
ECG repolarization abnormalities were followed
by repeated runs of
nonsustained polymorphic ventricular
tachycardia
(torsade de pointes) (Figure 2
), which caused
hemodynamic instability.
Intravenous
magnesium sulfate was administered, and the ECG
changes subsided
promptly (Figure 3
). An exercise test
performed
a few weeks later was negative for ischemia.
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Figure 2. ECG performed 12 hours after trauma. Deep,
symmetrical T-wave inversion in precordial leads, followed by
nonsustained polymorphic ventricular
tachycardia.
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Figure 3. An ECG performed 10 minutes after administration
of intravenous magnesium sulfate, showing no repolarization
abnormalities.
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Life-threatening arrhythmias, including
atrioventricular blocks, ventricular
tachycardia, and fibrillation, may accompany acute cerebral
accidents in patients without cardiac disease. Therefore, after acute
cerebrovascular events, patients should be constantly monitored, and
the treating team should be familiar with and well-trained in the
diagnosis and treatment of cardiac
arrhythmias.
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Footnotes
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The editor of Images in Cardiovascular Medicine is Hugh A. McAllister,
Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal
Hospital and Texas Heart Institute, and Clinical Professor of
Pathology, University of Texas Medical School and Baylor College
of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
