Cardiogenic shock secondary to metamizole-induced type II Kounis syndrome.
نویسندگان
چکیده
No further incidents have been documented during patient follow-up. In the cases presented, the mechanism underlying the induction of ventricular fibrillation could have been due to the continuous transmission—through the ventricular electrode to the interface with the myocardium—of the electrocautery radiofrequency pulses applied to the surrounding tissue or the pacemaker generator itself, although long pulses were not applied and it was programmed in bipolar mode in both cases. The cases presented raise the issue of possible complications with the use of electrocautery, especially in patients with cardiovascular implantable electronic devices. Although the frequency of complications is low, they are potentially fatal, and therefore a number of precautionary measures should be applied, including placing the dispersive pad as far from the generator as possible, reducing the energy pulses to less than 5 s’ duration and, as a matter of course and in all cases, having continuous monitoring and advanced resuscitation equipment available during the procedure. Nevertheless, as long as the risk of bleeding is not especially high, a cold scalpel, with careful dissection followed by complete homeostasis, may be sufficient, thus completely avoiding the use of the electric scalpel in many of these interventions.
منابع مشابه
Kounis syndrome presenting with acute inferior wall myocardial infarction and cardiogenic shock secondary to intravenous ampicillin/sulbactam administration
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عنوان ژورنال:
- Revista espanola de cardiologia
دوره 65 12 شماره
صفحات -
تاریخ انتشار 2012