Udongwo Ndausung, Gor Dhairya, Wiseman Kyle, Alshami Abbas, Daniels Steven
Internal Medicine, Jersey Shore University Medical Center, Neptune, USA.
Cardiology, Jersey Shore University Medical Center, Neptune, USA.
Cureus. 2021 Aug 14;13(8):e17175. doi: 10.7759/cureus.17175. eCollection 2021 Aug.
Cardiovascular conduction delay makes up part of the triad associated with Kearns-Sayre syndrome (KSS). Although there have been a few reported cases of prolonged Qtc and polymorphic ventricular tachycardia associated with this disease, despite the use of automatic implantable cardioverter defibrillators (AICD) for secondary prevention, some cases have been reported where the use of AICD did not help. We present a case of a 62-year-old male with KSS who came to the emergency department (ED) after two episodes of syncope. He already had an automatic AICD placed at the age of 34. Our patient had Qtc prolongation which is an unusual finding in KSS. He also had recurrent ventricular tachycardia (VT) refractory to medications and multiple shocks from his AICD, which progressed to a VT storm. He eventually passed away after the withdrawal of care, as his prognosis worsened. We recommend that a more clear guideline will help manage this devastating disease, resulting in mortality reduction.
心血管传导延迟是与卡恩斯-塞尔综合征(KSS)相关的三联征的一部分。尽管已有一些报道称该疾病会出现QTc延长和多形性室性心动过速,并且尽管使用了植入式自动心脏复律除颤器(AICD)进行二级预防,但仍有一些病例报告显示使用AICD并无帮助。我们报告一例62岁患有KSS的男性患者,该患者在经历两次晕厥发作后前往急诊科(ED)。他在34岁时已植入自动AICD。我们的患者存在QTc延长,这在KSS中是不常见的发现。他还患有复发性室性心动过速(VT),药物治疗无效且AICD多次电击均无法终止,最终发展为室性心动过速风暴。由于预后恶化,在停止治疗后他最终去世。我们建议制定更明确的指南将有助于管理这种毁灭性疾病,从而降低死亡率。