Abstract
Fifty-nine-year-old male patient had a sudden cardiac arrest (CA) while waiting for his appointment at the urology outpatient clinic. The local staff and the rapid response team (RRT) promptly started cardiopulmonary resuscitation maneuvers. Initial CA rhythm was ventricular fibrillation (VF) and the collapse-shock interval was five minutes. Return of spontaneous circulation (ROSC) occurred on the following cycle, comprising six minutes of arrest. There was not enough time to administer epinephrine or any other drugs. After ROSC, a definitive airway was [...]
Highlights
Fifty-nine-year-old male patient had a sudden cardiac arrest (CA) while waiting for his appointment at the urology outpatient clinic
The patient had been submitted to a myocardial perfusion scintigraphy in the year before and there were no signs of stress-induced ischemia
Long QT syndrome (LQTS) is associated with a specific polymorphic ventricular tachycardia (VT), named as torsades de pointes (TdP), because of the characteristic shift in the QRS axis that gives the impression of a “torsion”
Summary
Fifty-nine-year-old male patient had a sudden cardiac arrest (CA) while waiting for his appointment at the urology outpatient clinic. The patient was immediately referred to the Emergency Department for parenteral calcium supplementation and monitoring of kidney function, but left the hospital before medical evaluation. Two weeks after this episode, he returned to the hospital for a previously scheduled appointment in the urology department for follow-up of kidney transplant, reporting progressive weakness, stiffness and cramps, and experienced CA shortly after. The ECG at that time exhibited normal QT interval (cQT 436ms) (Figure 1C), with normal calcium serum levels after supplementation (ionized calcium of 5.84 mg/dL and total calcium of 9.5mg/dL)
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