Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report
Introduction: Bidirectional ventricular tachycardia (BVT) is a rare arrhythmia characterized by QRS complexes with an axis in the frontal plane alternating polarity in the precordial leads and right bundle branch block (RBBB) morphology. To the best of our knowledge, there is no previous report in...
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Tehran University of Medical Sciences
2019-10-01
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doaj-3fdc40a81141417096af4af600f449b02020-11-25T02:43:18ZengTehran University of Medical SciencesAdvanced Journal of Emergency Medicine2588-400X2019-10-0110.22114/ajem.v0i0.287Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case ReportDalton Argean Norwood0Lucia Belem Dominguez1Ricardo Leonel Dominguez2Walter Tyler Winders3Hospital de Occidente, Santa Rosa de Copan, HondurasHospital de Occidente, Santa Rosa de Copan, HondurasHospital de Occidente, Santa Rosa de Copan, HondurasDepartment of Emergency Medicine, Medical University of South Carolina, Charleston, USA Introduction: Bidirectional ventricular tachycardia (BVT) is a rare arrhythmia characterized by QRS complexes with an axis in the frontal plane alternating polarity in the precordial leads and right bundle branch block (RBBB) morphology. To the best of our knowledge, there is no previous report in dilated cardiomyopathy or in the context of a probable peripartum cardiomyopathy. Case Presentation: A 26-year-old, 9-month female patient, with no significant past medical history (the patient denies medication intake, herbs like aconite, trouble during delivery, any heart issues or family history of sudden death or cardiomyopathies) who presents to the emergency room due to 11 days of dyspnea, exacerbated by daily activities, orthopnea, and paroxysmal nocturnal dyspnea. She presented with ventricular bigeminy and systolic dysfunction with left ventricular ejection fraction (LVEF) <20%. The patient later developed a stable ventricular tachycardia (VT) treated with amiodarone, which resulted in hemodynamic instability and BVT rhythm with VT paroxysms. Without the possibility of ablation, the use of high dose beta blockers and an implantable cardioverter defibrillator resulted in the same rhythm with a lower heart rate, better NYHA functional class, and less episodes of VTs. Conclusion: BVT is a rare type of tachycardia that can be present in dilated cardiomyopathy. In the absence of ablation capabilities, decreasing the heart rate with beta-blockers may reduce the rate of paroxysmal VTs. http://ajem.tums.ac.ir/index.php/ajem/article/view/287Arrhythmias, CardiacBidirectional TachycardiaCardiomyopathy, DilatedTachycardia, Ventricular |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dalton Argean Norwood Lucia Belem Dominguez Ricardo Leonel Dominguez Walter Tyler Winders |
spellingShingle |
Dalton Argean Norwood Lucia Belem Dominguez Ricardo Leonel Dominguez Walter Tyler Winders Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report Advanced Journal of Emergency Medicine Arrhythmias, Cardiac Bidirectional Tachycardia Cardiomyopathy, Dilated Tachycardia, Ventricular |
author_facet |
Dalton Argean Norwood Lucia Belem Dominguez Ricardo Leonel Dominguez Walter Tyler Winders |
author_sort |
Dalton Argean Norwood |
title |
Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report |
title_short |
Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report |
title_full |
Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report |
title_fullStr |
Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report |
title_full_unstemmed |
Bidirectional Ventricular Tachycardia in a Women with Dilated Cardiomyopathy: A Case Report |
title_sort |
bidirectional ventricular tachycardia in a women with dilated cardiomyopathy: a case report |
publisher |
Tehran University of Medical Sciences |
series |
Advanced Journal of Emergency Medicine |
issn |
2588-400X |
publishDate |
2019-10-01 |
description |
Introduction: Bidirectional ventricular tachycardia (BVT) is a rare arrhythmia characterized by QRS complexes with an axis in the frontal plane alternating polarity in the precordial leads and right bundle branch block (RBBB) morphology. To the best of our knowledge, there is no previous report in dilated cardiomyopathy or in the context of a probable peripartum cardiomyopathy. Case Presentation: A 26-year-old, 9-month female patient, with no significant past medical history (the patient denies medication intake, herbs like aconite, trouble during delivery, any heart issues or family history of sudden death or cardiomyopathies) who presents to the emergency room due to 11 days of dyspnea, exacerbated by daily activities, orthopnea, and paroxysmal nocturnal dyspnea. She presented with ventricular bigeminy and systolic dysfunction with left ventricular ejection fraction (LVEF) <20%. The patient later developed a stable ventricular tachycardia (VT) treated with amiodarone, which resulted in hemodynamic instability and BVT rhythm with VT paroxysms. Without the possibility of ablation, the use of high dose beta blockers and an implantable cardioverter defibrillator resulted in the same rhythm with a lower heart rate, better NYHA functional class, and less episodes of VTs. Conclusion: BVT is a rare type of tachycardia that can be present in dilated cardiomyopathy. In the absence of ablation capabilities, decreasing the heart rate with beta-blockers may reduce the rate of paroxysmal VTs.
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topic |
Arrhythmias, Cardiac Bidirectional Tachycardia Cardiomyopathy, Dilated Tachycardia, Ventricular |
url |
http://ajem.tums.ac.ir/index.php/ajem/article/view/287 |
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