Yılmaz Fevzi, Beydilli Inan, Kavalcı Cemil, Yılmaz Serkan
Numune Research and Training Hospital, Department of Emergency, Ankara, Turkey.
Am J Case Rep. 2012;13:33-5. doi: 10.12659/AJCR.882594. Epub 2012 Mar 9.
Pregnancy can precipitate cardiac arrhythmias not previously present in seemingly well individuals. Atrial and ventricular premature beats are frequently present during pregnancy and are usually benign. Supraventricular tachycardia and malignant ventricular tachyarrhythmias occur less frequently. Maternal and fetal arrhythmias occurring during pregnancy may jeopardize the life of the mother and the fetus.
A 32-year-old pregnant women at 26 weeks gestation presented to the emergency department with palpitation. She had mild chest discomfort after a supraventricular tachycardia (SVT) episode but did not have syncope. After monitoring and access of an IV line, vagal manoeuvres were applied but the rhythm was resistant. Then she was treated with 5 mg metoprolol IV, but the SVT persisted. Then after IV infusion of adenosine triphosphate 6 to 12 mg, the rhythm was resistant. Synchronized cardioversion with 100 joules was performed. Patients' rhythm was normalized to a sinus rhythm. She was discharged from hospital without any adverse effects following 24-hour monitoring.
All pregnant patients with SVT require careful maternal and fetal monitoring during treatment, and close collaboration between the managing obstetrician and the cardiologist is essential.
妊娠可引发看似健康的个体先前未曾出现过的心律失常。孕期常出现房性和室性早搏，且通常为良性。室上性心动过速和恶性室性心律失常较少见。孕期发生的母体和胎儿心律失常可能危及母亲和胎儿的生命。
一名妊娠26周的32岁孕妇因心悸就诊于急诊科。她在一次室上性心动过速（SVT）发作后有轻度胸部不适，但未发生晕厥。在监测并建立静脉通路后，实施了迷走神经操作，但心律未转复。随后给予她5毫克静脉注射美托洛尔治疗，但室上性心动过速仍持续存在。接着静脉输注6至12毫克三磷酸腺苷后，心律仍未转复。进行了100焦耳的同步心脏复律。患者的心律恢复为窦性心律。在24小时监测后，她出院且未出现任何不良反应。
所有患有室上性心动过速的孕妇在治疗期间都需要对母体和胎儿进行仔细监测，产科医生和心脏病专家之间密切合作至关重要。
